Individual
MR. ELVIS MBENG NGWEDJANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5201 QUINCY ST APT B2, BLADENSBURG, MD 20710-2331
(240) 764-9672
Mailing address
5201 QUINCY ST APT B2, BLADENSBURG, MD 20710-2331
(240) 764-9672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LIN1890288070
WORK PERMIT
NJ
Enumeration date
09/06/2018
Last updated
07/27/2023
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