Provider Demographics
NPI:1013271261
Name:EKANEWANG, REMY EBUNG
Entity Type:Individual
Prefix:
First Name:REMY
Middle Name:EBUNG
Last Name:EKANEWANG
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 1:14009 BRAMBLE LN APT T2
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1222
Mailing Address - Country:US
Mailing Address - Phone:240-440-0433
Mailing Address - Fax:
Practice Address - Street 1:14009 BRAMBLE LN APT T2
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1222
Practice Address - Country:US
Practice Address - Phone:240-440-0433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle