Individual
GEORGE TANKET NDIFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5804 ANNAPOLIS RD APT 310, BLADENSBURG, MD 20710-2012
(240) 739-5265
Mailing address
5804 ANNAPOLIS RD APT 310, BLADENSBURG, MD 20710-2012
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/10/2023
Last updated
06/13/2023
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