Provider Demographics
NPI:1538960844
Name:YUFENYU, ROGER
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:YUFENYU
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3203
Mailing Address - Country:US
Mailing Address - Phone:240-259-1411
Mailing Address - Fax:
Practice Address - Street 1:8901 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3203
Practice Address - Country:US
Practice Address - Phone:240-259-1411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-22
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker