Basic Information
| Provider Information | |||||||||
| NPI: | 1174186803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONTEH | ||||||||
| FirstName: | AUGUSTINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15104 DENNINGTON DR | ||||||||
| Address2: | |||||||||
| City: | BOWIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207213257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2407041362 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2512 24TH ST NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200182126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328340 | ||||||||
| FaxNumber: | 2028328341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2019 | ||||||||
| LastUpdateDate: | 04/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN1052271 | DC | Y | Nursing Service Providers | Registered Nurse |
No ID Information.