Individual
IFEYINWA MADUKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12304 BALTIMORE AVE STE A, BELTSVILLE, MD 20705-1314
(301) 383-0142
Mailing address
12100 ANNAPOLIS RD UNIT 2, GLENN DALE, MD 20769-9179
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R178338
MD
Other
Enumeration date
01/16/2020
Last updated
01/24/2020
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