Provider Demographics
NPI:1952012338
Name:MARYLAND HEALTH AND WELLNESS SOLUTION LLC
Entity Type:Organization
Organization Name:MARYLAND HEALTH AND WELLNESS SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MODEST
Authorized Official - Middle Name:TAH
Authorized Official - Last Name:NDANGOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-988-9624
Mailing Address - Street 1:6201 GREENBELT RD UNIT 18
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2354
Mailing Address - Country:US
Mailing Address - Phone:301-307-2611
Mailing Address - Fax:301-812-4190
Practice Address - Street 1:6201 GREENBELT RD UNIT 18
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:301-307-2611
Practice Address - Fax:301-812-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty