Provider Demographics
NPI:1891042966
Name:NGAMO, RICHARD D
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:NGAMO
Suffix:
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 1:1707 L ST NW
Mailing Address - Street 2:SUITE 900
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4201
Mailing Address - Country:US
Mailing Address - Phone:202-829-1111
Mailing Address - Fax:
Practice Address - Street 1:1707 L ST NW
Practice Address - Street 2:SUITE 900
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4201
Practice Address - Country:US
Practice Address - Phone:202-829-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN964508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse