Provider Information for 1093226425
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Ms. GLADYS PAYNE
Sex: Female
NPI: 1093226425
Last Updated: 2024-09-23
Certification Date: 2024-09-23
Certification Date: 2024-09-23
Details
Name | Value | ||||||||
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NPI | 1093226425 | ||||||||
Enumeration Date | 2017-10-12 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 903 BRIGHTSEAT RD LANDOVER, MD 20785-4725 United States Phone: 301-278-1194 | Fax: | ||||||||
Primary Practice Address | 903 BRIGHTSEAT RD LANDOVER, MD 20785-4725 United States Phone: 301-278-1194 | Fax: | ||||||||
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