Individual
MBU MADU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9883 GOOD LUCK RD, LANHAM, MD 20706-3215
(240) 825-7198
Mailing address
9883 GOOD LUCK RD, LANHAM, MD 20706-3215
(240) 825-7198
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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