Provider Demographics
NPI:1760171128
Name:ACHEM, REGINA ERANG
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:ERANG
Last Name:ACHEM
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 1:10978 STELLA CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-5942
Mailing Address - Country:US
Mailing Address - Phone:240-374-8941
Mailing Address - Fax:
Practice Address - Street 1:10978 STELLA CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-5942
Practice Address - Country:US
Practice Address - Phone:240-374-8941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator