Healthcare Provider Details

I. General information

NPI: 1477916971
Provider Name (Legal Business Name): WILMINA NHOUE'DEH LANDFORD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 09/07/2024
Certification Date: 09/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 WISCONSIN AVE STE 515
BETHESDA MD
20814-4998
US

IV. Provider business mailing address

7201 WISCONSIN AVE STE 515
BETHESDA MD
20814-4998
US

V. Phone/Fax

Practice location:
  • Phone: 410-502-7381
  • Fax:
Mailing address:
  • Phone: 410-502-7381
  • Fax: 917-900-1487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberD0095362
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: