Provider Demographics
NPI:1073120523
Name:DARBY, RAYMON
Entity type:Individual
Prefix:
First Name:RAYMON
Middle Name:
Last Name:DARBY
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 1:5407 MACBETH ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1009
Mailing Address - Country:US
Mailing Address - Phone:240-821-0096
Mailing Address - Fax:
Practice Address - Street 1:5407 MACBETH ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1009
Practice Address - Country:US
Practice Address - Phone:240-821-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program