Provider Demographics
NPI:1124795430
Name:PAYNE, ELSON NDOH
Entity type:Individual
Prefix:
First Name:ELSON
Middle Name:NDOH
Last Name:PAYNE
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 1:333 KENDRICK DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2352
Mailing Address - Country:US
Mailing Address - Phone:144-327-1925
Mailing Address - Fax:
Practice Address - Street 1:333 KENDRICK DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2352
Practice Address - Country:US
Practice Address - Phone:144-327-1925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide