Provider Demographics
NPI:1689416737
Name:NGUATEM, BRIGHT JUNIOR
Entity type:Individual
Prefix:
First Name:BRIGHT
Middle Name:JUNIOR
Last Name:NGUATEM
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 1:9328 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LANHAM SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3119
Mailing Address - Country:US
Mailing Address - Phone:301-524-5907
Mailing Address - Fax:
Practice Address - Street 1:9328 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LANHAM SEABROOK
Practice Address - State:MD
Practice Address - Zip Code:20706-3119
Practice Address - Country:US
Practice Address - Phone:301-524-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide