Provider Demographics
NPI:1750643367
Name:ANYANGWE, ENJEH MANDI
Entity Type:Individual
Prefix:
First Name:ENJEH
Middle Name:MANDI
Last Name:ANYANGWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11410 FALCON RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1446
Mailing Address - Country:US
Mailing Address - Phone:240-470-9290
Mailing Address - Fax:
Practice Address - Street 1:11410 FALCON RIDGE CT
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1446
Practice Address - Country:US
Practice Address - Phone:240-470-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-10
Last Update Date:2012-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide