Most Relevant Information
Provider Data
| NPI Number: | 1003514365 |
| Provider Name: | CROMWELL MUNDAM |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/16/2023 |
| Last Updated: | 07/27/2023 |
Provider Practice Location
2811 PENNSYLVANIA AVE
WASHINGTON
DC
200203011
Practice Location Phone/Fax
| Phone: | 2028946811 |
| Fax: | 2028946811 |
Provider Mailing Location
10037 LOCUST ST GLENDALE
GLENDALE
MD
20769
Provider Mailing Phone/Fax
| Phone: | 2409700903 |
| Fax: |