Individual
DIDACUS TAMAMBANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6811 W FOREST RD APT 103, HYATTSVILLE, MD 20785-3331
(240) 714-1211
Mailing address
6811 W FOREST RD APT 103, HYATTSVILLE, MD 20785-3331
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA12187
WA
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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