Provider Demographics
NPI:1952651614
Name:NGALAMO, MICHEL
Entity Type:Individual
Prefix:MR
First Name:MICHEL
Middle Name:
Last Name:NGALAMO
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 1:925 NORTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2555
Mailing Address - Country:US
Mailing Address - Phone:240-704-4494
Mailing Address - Fax:
Practice Address - Street 1:925 NORTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2555
Practice Address - Country:US
Practice Address - Phone:240-704-4494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program