NPI 1366874570

Matthew Patrick Momoh

Practitioner Exclusive Provider Organization Upper Marlboro, MD

Practice location

Address: 216 Prenton St, Upper Marlboro, MD 20774-1534
Phone: (240) 550-9972

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 000119 (DC)

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Registry record

NPI: 1366874570
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jul 2013
Record last updated: 30 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.