Individual
GUY MODESTE NDEH ETIMBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3406 54TH AVE, HYATTSVILLE, MD 20784-1002
(240) 716-8719
Mailing address
3406 54TH AVE, HYATTSVILLE, MD 20784-1002
(240) 716-8719
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/03/2020
Last updated
07/13/2020
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