Provider Demographics
NPI:1205612975
Name:NKENG, ERIC AWUNGNJIA
Entity type:Individual
Prefix:
First Name:ERIC AWUNGNJIA
Middle Name:
Last Name:NKENG
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 1:12700 MARLBORO POINTE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6028
Mailing Address - Country:US
Mailing Address - Phone:240-791-2394
Mailing Address - Fax:
Practice Address - Street 1:12700 MARLBORO POINTE DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-6028
Practice Address - Country:US
Practice Address - Phone:240-791-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide