Individual
DIEUDONNE METOMBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
9906 STALL AVE, LANHAM, MD 20706-2379
(513) 371-2802
Mailing address
9906 STALL AVE, LANHAM, MD 20706-2379
(513) 371-2802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
135231
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R227138
MD
Other
Enumeration date
05/14/2012
Last updated
02/08/2024
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