Organization
J & G FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGUM AVWONTOM FNP-BC (PRESIDENT)
(301) 404-1989
Entity
Organization
Contact information
Practice address
6614 WINDSOR MILL RD, GWYNN OAK, MD 21207-5381
(301) 404-1989
Mailing address
6614 WINDSOR MILL RD, GWYNN OAK, MD 21207-5381
(301) 404-1989
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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