Provider Demographics
NPI:1376384149
Name:MBOUEMBOUE, JOUNAIDOU NSANGOU (MD)
Entity type:Individual
Prefix:DR
First Name:JOUNAIDOU
Middle Name:NSANGOU
Last Name:MBOUEMBOUE
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 1:2545 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7300
Mailing Address - Country:US
Mailing Address - Phone:610-402-8000
Mailing Address - Fax:
Practice Address - Street 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:610-402-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT232230207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty