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Individual

MRS. TOM BASSEY EDUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
617 STEMMERS RUN RD STE I, BALTIMORE, MD 21221-3361
(443) 453-2069
(443) 559-5645
Mailing address
617 STEMMERS RUN RD STE I, BALTIMORE, MD 21221-3361
(443) 453-2069
(443) 559-5645

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R4294
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
82-5242842
MD
Enumeration date
08/03/2018
Last updated
02/19/2024
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