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NPI Code Detail

MEDICARE: NGUMBAH S CHUMBOW

MEDICARE:   NGUMBAH S CHUMBOW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN107079DC

General Provider Information

NPI Number : 1205312865
Entity Type Code : Individual
Provider Name (Legal Business Name) : NGUMBAH S CHUMBOW
Provider Business Mailing Address
First Line : 8147 BAYOU BEND BLVD
Second Line :
City : LAUREL
State : MD
Zip : 20724-1962
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8147 BAYOU BEND BLVD
Second Line :
City : LAUREL
State : MD
Zip : 20724-1962
Country : US
Telephone Number : 240-476-9658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 07/17/2018

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Directions to “ NGUMBAH S CHUMBOW ” Practice Location

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