Provider Demographics
NPI:1427806967
Name:AMINKENG, EFUETNGU
Entity type:Individual
Prefix:
First Name:EFUETNGU
Middle Name:
Last Name:AMINKENG
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 1:9614 MEADOW LARK AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-3862
Mailing Address - Country:US
Mailing Address - Phone:301-892-0887
Mailing Address - Fax:
Practice Address - Street 1:9614 MEADOW LARK AVE
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-3862
Practice Address - Country:US
Practice Address - Phone:301-892-0887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00213276374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide