Individual
THERESA E NGWANA-MONDOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9901 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3357
(301) 279-6480
Mailing address
PO BOX 100445, ATLANTA, GA 30384-0445
(888) 627-4702
(804) 253-0408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0057882
MD
2080N0001X
Neonatal-Perinatal Medicine Physician
D0057882
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810012438
—
WV
05
—
3840018
—
MD
Enumeration date
10/26/2005
Last updated
11/19/2008
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