Individual
CHI NDIFOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11400 BELVIDERE RD, BOWIE, MD 20721-2122
(240) 714-7869
Mailing address
11400 BELVIDERE RD, BOWIE, MD 20721-2122
(240) 714-7869
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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