Individual
FLINT NWANGUMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 MILFORD MILL RD, PIKESVILLE, MD 21208-6000
(443) 613-2567
(410) 602-8449
Mailing address
222 MILFORD MILL RD, PIKESVILLE, MD 21208-6000
(443) 613-2567
(410) 602-8449
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-3900711
—
MD
Enumeration date
12/10/2020
Last updated
03/15/2022
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