Provider Demographics
NPI:1346063369
Name:ANNU, DEFANG
Entity type:Individual
Prefix:
First Name:DEFANG
Middle Name:
Last Name:ANNU
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 1:7955 RIGGS RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4565
Mailing Address - Country:US
Mailing Address - Phone:281-818-1189
Mailing Address - Fax:
Practice Address - Street 1:7955 RIGGS RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4565
Practice Address - Country:US
Practice Address - Phone:281-818-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide