Provider Demographics
NPI:1205427366
Name:NGWA, CHEWAH
Entity type:Individual
Prefix:
First Name:CHEWAH
Middle Name:
Last Name:NGWA
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 1:9757 GOOD LUCK RD APT 7
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3327
Mailing Address - Country:US
Mailing Address - Phone:240-906-7804
Mailing Address - Fax:
Practice Address - Street 1:9757 GOOD LUCK RD APT 7
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3327
Practice Address - Country:US
Practice Address - Phone:240-906-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000812913376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide