DERICK T MUKOM

GLENN DALE, MD
NPI1013892074
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies172V00000X Community Health Worker
Enumeration Date2025-08-08
Last Update Date2025-10-23
Business Address
DERICK T MUKOM
6911 FOUNTAIN PARK DR
GLENN DALE, MD 20769-9484
Phone number: 832-988-8970
Mailing Address
DERICK T MUKOM
6911 FOUNTAIN PARK DR
GLENN DALE, MD 20769-9484
Phone number: 832-988-8970
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