Randolph Asama Anagho
Individual provider Active NPI Licensed Practical Nurse · College Park, MD
NPI 1124370903 · NPPES record last updated Oct 4, 2012
Key facts
- NPI
- 1124370903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LPN1005057 (MD)
- Practice address
- 4709 Caddo Rd,
College Park, MD 20740 - Phone
- (202) 547-2949
- NPI assigned
- Oct 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPN1005057 | MD | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN1005057 | MD | Yes |
Addresses
Primary practice location
4709 Caddo Rd,
College Park, MD 20740
Mailing address
4709 Caddo Rd,
College Park, MD 20740
Phone (202) 547-2949
Other providers in College Park, MD
- Patrick B Amara
- Amazing Group LLC
- Ifa Ambomu
- Marta Catherine Amerein
- American Current Care P.a.
- Ananda Holistics and Wellness Clinic LLC
- Paula A Anderson
- Angel Healthcare Nursing
- Delphine Tamufor Angwi
- Antioch Primary Care LLC
All providers in College Park, MD · Licensed Practical Nurse in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.