Individual
JOSEPH ABANG TANYI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11967 BELTSVILLE DR, BELTSVILLE, MD 20705
(301) 765-4745
Mailing address
11967 BELTSVILLE DR, BELTSVILLE, MD 20705-4004
(301) 764-4745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
620439696
DC
171W00000X
Contractor
Primary
620439696
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IVERZON ONE
—
DC
Enumeration date
05/29/2012
Last updated
05/29/2012
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