Healthcare Provider Details

I. General information

NPI: 1144900200
Provider Name (Legal Business Name): DENIS NJONG NJONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 LAKEHOUSE ROAD APT. #21
BELTSVILLE MD
20705
US

IV. Provider business mailing address

3921 LAKEHOUSE ROAD APT. #21
BELTSVILLE MD
20705
US

V. Phone/Fax

Practice location:
  • Phone: 240-726-3799
  • Fax:
Mailing address:
  • Phone: 240-726-3799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: