Provider Demographics
NPI:1174885966
Name:NTADUN, ODILE NANA
Entity type:Individual
Prefix:
First Name:ODILE
Middle Name:NANA
Last Name:NTADUN
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 1:1804 MOUNT PISGAH LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2146
Mailing Address - Country:US
Mailing Address - Phone:240-478-4210
Mailing Address - Fax:
Practice Address - Street 1:1804 MOUNT PISGAH LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2146
Practice Address - Country:US
Practice Address - Phone:240-478-4210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide