Individual
FEMOS NEBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
902 22ND ST NE APT 102, WASHINGTON, DC 20002-3252
(202) 277-3325
Mailing address
902 22ND ST NE APT 102, WASHINGTON, DC 20002-3252
(202) 277-3325
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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