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General NPI Number Information
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NPI Number | 1942540083
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Entity Type | Individual
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Provider Name | LUM MERCY MAXIMUANGU NP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 40 S DUNDALK AVE STE 400
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City | DUNDALK
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State | MD
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Zip | 21222-4273
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Country | US
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Telephone | 410-431-1957
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Fax | 410-862-0150
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Provider Business Mailing Address
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Address Line | 1201 COLLEGE PARK DR STE 101
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City | DOVER
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State | DE
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Zip | 19904-8702
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Country | US
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Telephone | 302-741-0226
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Fax | 302-741-0335
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R150156
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0000123
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License Number State | DE
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