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General NPI Number Information
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NPI Number | 1225515042
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Entity Type | Individual
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Provider Name | VIVIAN WANGUI NDUNGU PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 2000 GWYNNS FALLS PKWY
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City | BALTIMORE
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State | MD
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Zip | 21216-3244
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Country | US
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Telephone | 443-627-2292
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Fax | 443-627-2295
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Provider Business Mailing Address
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Address Line | 2000 GWYNNS FALLS PKWY
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City | BALTIMORE
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State | MD
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Zip | 21216-3244
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Country | US
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Telephone | 443-627-2292
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Fax | 443-627-2295
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202216427
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 25218
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License Number State | MD
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