Individual
MODEST TAH NDANGOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6201 GREENBELT RD UNIT 18, BERWYN HEIGHTS, MD 20740-2354
(301) 307-2611
(301) 812-4190
Mailing address
6201 GREENBELT RD UNIT 18, BERWYN HEIGHTS, MD 20740-2354
(301) 307-2611
(301) 812-4190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R194971
MD
Other
Enumeration date
01/23/2018
Last updated
11/24/2020
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