Individual
DESEAN ROBERT FAUCETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 POST OFFICE RD, WALDORF, MD 20602-9998
(240) 353-4755
Mailing address
150 POST OFFICE RD, WALDORF, MD 20602-9998
(240) 353-4755
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
F-230-139-745-577
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F-230-139-745-577
N/A
MD
Enumeration date
02/04/2022
Last updated
02/04/2022
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