Individual
LINDA UWANAKA EBONINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 MERCANTILE LN, SUITE 200, LARGO, MD 20774-5341
(301) 773-4100
Mailing address
1400 MERCANTILE LN, SUITE 200, LARGO, MD 20774-5341
(301) 773-4100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0004463
MD
Other
Enumeration date
06/08/2011
Last updated
07/12/2013
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