Individual
KEVIN LONGANGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13950 BRANDYWINE RD, BRANDYWINE, MD 20613-5815
(301) 782-2250
Mailing address
10409 VISTA GARDENS DR, BOWIE, MD 20720-4234
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/23/2021
Last updated
10/27/2021
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