Provider Demographics
NPI:1699151217
Name:LECHINDEM, AWUNG THADDIUS
Entity type:Individual
Prefix:
First Name:AWUNG
Middle Name:THADDIUS
Last Name:LECHINDEM
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 1:6209 ERLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2481
Mailing Address - Country:US
Mailing Address - Phone:301-851-1765
Mailing Address - Fax:
Practice Address - Street 1:6209 ERLAND WAY
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2481
Practice Address - Country:US
Practice Address - Phone:301-851-1765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide