Provider Demographics
NPI:1003168964
Name:OFE, RAYMOND ASEH (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:ASEH
Last Name:OFE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 PIAFFE CIR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4680
Mailing Address - Country:US
Mailing Address - Phone:240-350-8841
Mailing Address - Fax:
Practice Address - Street 1:1300 MERCANTILE LN STE 200
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5340
Practice Address - Country:US
Practice Address - Phone:240-350-8841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily