Individual
POLICAP TENGEN TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9101 CHERRY LN STE 212, LAUREL, MD 20708-1116
(301) 213-1812
Mailing address
9101 CHERRY LN STE 212, LAUREL, MD 20708-1116
(301) 213-1812
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00189812
MD
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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