Provider Demographics
NPI:1225423445
Name:NGWA, GILBERT NEBA TANTOH (DR)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:NEBA TANTOH
Last Name:NGWA
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 LAKE CREST CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-5015
Mailing Address - Country:US
Mailing Address - Phone:205-515-0160
Mailing Address - Fax:
Practice Address - Street 1:466 FOREST LAKES DR
Practice Address - Street 2:
Practice Address - City:STERRETT
Practice Address - State:AL
Practice Address - Zip Code:35147-8166
Practice Address - Country:US
Practice Address - Phone:205-515-0160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist