Provider Demographics
NPI:1740067404
Name:OGUDO, ANTHONY U
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:U
Last Name:OGUDO
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 1:8919 91ST PL
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1911
Mailing Address - Country:US
Mailing Address - Phone:240-610-2870
Mailing Address - Fax:
Practice Address - Street 1:8919 91ST PL
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1911
Practice Address - Country:US
Practice Address - Phone:240-610-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide