MEDICARE: DAVID MBUGUA GACENGECI MD

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	2084P0800X	Psychiatry Physician	200101550	NC

General Provider Information

NPI Number	:	1942269592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MBUGUA GACENGECI MD

Provider Business Mailing Address
First Line	:	12012 WARWICKSHIRE WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-6020
Country	:	US
Telephone Number	:	919-332-1641
Fax Number	:	919-866-1623

Provider Business Practice Location Address
First Line	:	1033 DRESSER CT
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7323
Country	:	US
Telephone Number	:	919-332-1641
Fax Number	:

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	12/04/2023

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