Provider Demographics
NPI:1629235759
Name:HEBOU, ANNICK PAYONG CHIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNICK
Middle Name:PAYONG CHIMA
Last Name:HEBOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3500 OLD WASHINGTON RD STE 102
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3205
Mailing Address - Country:US
Mailing Address - Phone:240-514-2323
Mailing Address - Fax:240-514-8851
Practice Address - Street 1:3500 OLD WASHINGTON RD STE 102
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3205
Practice Address - Country:US
Practice Address - Phone:240-514-2323
Practice Address - Fax:240-514-8851
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0092835207R00000X
DCMD036989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine