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Individual

GEORGIA E BEWAYO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6 GARRETT AVENUE, LA PLATA, MD 20646-4010
(301) 539-5100
(301) 934-2084
Mailing address
4639 DIAMOND RIDGE LN, WHITE PLAINS, MD 20695-3103
(301) 396-5753

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F1106110
NC
363LF0000X
Family Nurse Practitioner
Primary
R179194
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
330813800
MD
Enumeration date
01/17/2007
Last updated
02/16/2023
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