Provider Demographics
NPI:1104646207
Name:ANJOH, SIDONIE
Entity type:Individual
Prefix:MS
First Name:SIDONIE
Middle Name:
Last Name:ANJOH
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 1:2316 NICOL CIR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2851
Mailing Address - Country:US
Mailing Address - Phone:240-923-0755
Mailing Address - Fax:
Practice Address - Street 1:2316 NICOL CIR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2851
Practice Address - Country:US
Practice Address - Phone:240-923-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator