MEDICARE: CAROL NDUMU

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1811231988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL NDUMU

Provider Business Mailing Address
First Line	:	3143 SOUTHGATE DR
Second Line	:	APT 10
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-6621
Country	:	US
Telephone Number	:	202-460-2164
Fax Number	:

Provider Business Practice Location Address
First Line	:	7835 EASTERN AVE
Second Line	:	STE 209
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4825
Country	:	US
Telephone Number	:	202-400-3636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	11/15/2012

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Directions to “ CAROL NDUMU ” Practice Location

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