Provider Demographics
NPI:1033811815
Name:POINDEXTER, TORRANCE M (MBA)
Entity Type:Individual
Prefix:
First Name:TORRANCE
Middle Name:M
Last Name:POINDEXTER
Suffix:
Gender:M
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 TESTWAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2451
Mailing Address - Country:US
Mailing Address - Phone:240-381-9139
Mailing Address - Fax:
Practice Address - Street 1:2703 TESTWAY AVE
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2451
Practice Address - Country:US
Practice Address - Phone:240-381-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker