Provider Demographics
NPI:1740752815
Name:NDIFOR, DIEUDONNE CHE
Entity Type:Individual
Prefix:DR
First Name:DIEUDONNE
Middle Name:CHE
Last Name:NDIFOR
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 1:8500 NEW HAMPSHIRE AVE APT 129
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3317
Mailing Address - Country:US
Mailing Address - Phone:202-602-9799
Mailing Address - Fax:
Practice Address - Street 1:8500 NEW HAMPSHIRE AVE APT 129
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3317
Practice Address - Country:US
Practice Address - Phone:202-602-9799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT872403225100000X
MD27258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist