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MINGO BOARDS
Nurse Practitioner
NPI: 1821727702Individual
Specialties, Licenses & Credentials
Nurse PractitionerPrimary
Nurse Practitioner
Code: 363L00000X
R237193(MD)
CMS Specialties
PrimaryNURSE PRACTITIONER
Education
OTHER
Class of 2022
Contact & Hours
- Address
- 4305 SPRING FOAL CT
UPPER MARLBORO, MD 20772 - Phone
- (843) 601-7525
Quick Facts
- NPI
- 1821727702
- Entity Type
- Individual
- Gender
- Male
- Medicare
- Not confirmed
- Specialties
- 1
- Locations
- 1
- Years in Practice
- 4
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