Individual
IUDOK PREMOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1050 W PERIMETER RD, PEDIATRIC CLINIC, ANDREWS AFB, MD 20762-6601
(240) 857-2723
(240) 857-6263
Mailing address
1058 WEST PERIMETER ROAD, PEDIATRIC CLINIC, ANDREWS AFB, MD 20762
(240) 857-2723
(240) 857-6263
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R114085
MD
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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