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Individual

LEONARD MUGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4611 SOUTHWOOD AVE, BALTIMORE, MD 21206-2245
(410) 900-4619
Mailing address
7120 SAMUEL MORSE DR STE 140, COLUMBIA, MD 21046-3421

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R181805
MD
363LG0600X
Gerontology Nurse Practitioner
Primary
R181805
MD

Other

Enumeration date
12/13/2016
Last updated
09/19/2024
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