Individual
NELSON FOKOBO MUTAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1836 METZEROTT RD, ADELPHI, MD 20783-3475
(929) 366-6292
Mailing address
1836 METZEROTT RD, ADELPHI, MD 20783-3475
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00194735
MD
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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