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Individual

MR. GEDEON LONGTCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
2454 VINEYARD LN, CROFTON, MD 21114-1116
(240) 353-2357
Mailing address
2454 VINEYARD LN, CROFTON, MD 21114-1116
(240) 353-2357

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R199900
MD
363LF0000X
Family Nurse Practitioner
RN1026502
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R162583
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1689157331
MD
Enumeration date
09/10/2018
Last updated
06/01/2022
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