Individual
DERICK TANTO NYAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
423 KETTERING DR, UPPER MARLBORO, MD 20774-1522
(301) 531-0887
Mailing address
423 KETTERING DR, UPPER MARLBORO, MD 20774-1522
(301) 531-0887
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
200004455
DC
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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