Provider Demographics
NPI:1487098521
Name:MANGA WILLIAMS, HEDWIG E (NP-C)
Entity type:Individual
Prefix:
First Name:HEDWIG
Middle Name:E
Last Name:MANGA WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 CHANCELSORS DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-8194
Mailing Address - Country:US
Mailing Address - Phone:240-605-5215
Mailing Address - Fax:301-982-6488
Practice Address - Street 1:13994 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5087
Practice Address - Country:US
Practice Address - Phone:301-477-2128
Practice Address - Fax:301-477-1758
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
MDR209823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No374U00000XNursing Service Related ProvidersHome Health Aide