Provider Demographics
NPI:1447774849
Name:BIKUNDI, MIKE DAVIS JR
Entity Type:Individual
Prefix:MR
First Name:MIKE
Middle Name:DAVIS
Last Name:BIKUNDI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 24TH ST NE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1936
Mailing Address - Country:US
Mailing Address - Phone:571-343-9735
Mailing Address - Fax:
Practice Address - Street 1:1810 24TH ST NE APT 203
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1936
Practice Address - Country:US
Practice Address - Phone:571-343-9735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker