Individual
CHARLES MENSAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14203 WOLF CREEK PL, ASPEN HILL, MD 20906-6196
(240) 421-6567
Mailing address
1703 HEATHER LN, FREDERICK, MD 21702-3040
(240) 421-6567
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M-520-115-161-711
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3177
WMATC
MD
Enumeration date
10/03/2018
Last updated
10/03/2018
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