Provider Demographics
NPI:1336851922
Name:ENYONG, PAMELA AWU
Entity Type:Individual
Prefix:
First Name:PAMELA AWU
Middle Name:
Last Name:ENYONG
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 1:25 JOYCETON TER
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1491
Mailing Address - Country:US
Mailing Address - Phone:240-722-5392
Mailing Address - Fax:
Practice Address - Street 1:25 JOYCETON TER
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1491
Practice Address - Country:US
Practice Address - Phone:240-722-5392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide