Provider Demographics
NPI:1619341377
Name:MARINUS, NDIFOR
Entity Type:Individual
Prefix:MR
First Name:NDIFOR
Middle Name:
Last Name:MARINUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 PINEY BRANCH RD
Mailing Address - Street 2:APT 206
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2867
Mailing Address - Country:US
Mailing Address - Phone:404-644-9956
Mailing Address - Fax:
Practice Address - Street 1:9314 PINEY BRANCH RD
Practice Address - Street 2:APT 206
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2867
Practice Address - Country:US
Practice Address - Phone:404-644-9956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide