Provider Demographics
NPI:1407077134
Name:NDIRANGU, MAGDALINE WAMBUI (MD)
Entity Type:Individual
Prefix:
First Name:MAGDALINE
Middle Name:WAMBUI
Last Name:NDIRANGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:675 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4900
Practice Address - Country:US
Practice Address - Phone:757-436-7888
Practice Address - Fax:757-548-5669
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048022207Q00000X
VA0101251754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8496499Medicaid
WAAB32999OtherMEDICARE GROUP
WAG8868461Medicare PIN