Individual
BERTINE FANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11449 CHERRY HILL RD APT 103, BELTSVILLE, MD 20705-3646
(240) 360-3419
(240) 360-3419
Mailing address
11449 CHERRY HILL RD APT 103, BELTSVILLE, MD 20705-3646
(240) 360-3419
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12904
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA12904
—
DC
Enumeration date
07/20/2017
Last updated
07/20/2017
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