Provider Demographics
NPI:1275219040
Name:EFFANGE, DOREEN EFETI
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:EFETI
Last Name:EFFANGE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DOREEN
Other - Middle Name:
Other - Last Name:EFETI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DHSC, MPH, MBA
Mailing Address - Street 1:25400 DAMASCUS PARK TER
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872
Mailing Address - Country:US
Mailing Address - Phone:240-472-7044
Mailing Address - Fax:
Practice Address - Street 1:25400 DAMASCUS PARK TER
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872
Practice Address - Country:US
Practice Address - Phone:240-472-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator