Provider Demographics
NPI:1366872376
Name:NOWA, REGIS MARTIAL
Entity type:Individual
Prefix:
First Name:REGIS
Middle Name:MARTIAL
Last Name:NOWA
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 1:9919 GOOD LUCK RD
Mailing Address - Street 2:202
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3253
Mailing Address - Country:US
Mailing Address - Phone:202-722-7776
Mailing Address - Fax:
Practice Address - Street 1:9919 GOOD LUCK RD
Practice Address - Street 2:202
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3253
Practice Address - Country:US
Practice Address - Phone:202-722-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide