Provider Demographics
NPI:1962107359
Name:MENDO MBI, NTOKWO JOSHUA
Entity type:Individual
Prefix:
First Name:NTOKWO JOSHUA
Middle Name:
Last Name:MENDO MBI
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 1:8501 CORY DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4458
Mailing Address - Country:US
Mailing Address - Phone:240-639-3786
Mailing Address - Fax:
Practice Address - Street 1:8501 CORY DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4458
Practice Address - Country:US
Practice Address - Phone:240-639-3786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator