Provider Demographics
NPI:1629803119
Name:TEMBAN, PAUL TEMBAN
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:TEMBAN
Last Name:TEMBAN
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 1:10010 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9209
Mailing Address - Country:US
Mailing Address - Phone:240-413-0243
Mailing Address - Fax:
Practice Address - Street 1:10010 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9209
Practice Address - Country:US
Practice Address - Phone:240-413-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide