Provider Demographics
NPI:1881955235
Name:DJUAZONG SAO, MYRIANE
Entity type:Individual
Prefix:
First Name:MYRIANE
Middle Name:
Last Name:DJUAZONG SAO
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 1:11700 OLD COLUMBIA PIKE APT 212
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2551
Mailing Address - Country:US
Mailing Address - Phone:240-278-1420
Mailing Address - Fax:
Practice Address - Street 1:11700 OLD COLUMBIA PIKE APT 212
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2551
Practice Address - Country:US
Practice Address - Phone:240-278-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171M00000XOther Service ProvidersCase Manager/Care Coordinator