Provider Demographics
NPI:1588806244
Name:NKEMBE, KWAMBA EKWA (MD)
Entity Type:Individual
Prefix:
First Name:KWAMBA
Middle Name:EKWA
Last Name:NKEMBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 T B STANLEY HWY
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-6108
Mailing Address - Country:US
Mailing Address - Phone:276-629-1076
Mailing Address - Fax:276-629-2695
Practice Address - Street 1:324 T B STANLEY HWY
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055-6108
Practice Address - Country:US
Practice Address - Phone:276-629-1076
Practice Address - Fax:276-629-2695
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252583208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice