Provider Demographics
NPI:1821512849
Name:NDAM, ENGONWIE
Entity Type:Individual
Prefix:
First Name:ENGONWIE
Middle Name:
Last Name:NDAM
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 1:1909 TREETOP LN APT 13
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6621
Mailing Address - Country:US
Mailing Address - Phone:240-467-6756
Mailing Address - Fax:
Practice Address - Street 1:4760 C ST SE APT 202
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-6286
Practice Address - Country:US
Practice Address - Phone:240-467-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide