Individual
MR. SUNNY BESONG DIFFANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3523 CORN STREAM RD, RANDALLSTOWN, MD 21133-2442
(410) 528-3866
Mailing address
3523 CORN STREAM RD, RANDALLSTOWN, MD 21133-2442
(410) 528-3866
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R202090
MD
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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