Provider Demographics
NPI:1669151239
Name:NDIKUM, MARIEPASCALE NDAH (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:MARIEPASCALE
Middle Name:NDAH
Last Name:NDIKUM
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:DR
Other - First Name:MARIEPASCALE
Other - Middle Name:NDAH
Other - Last Name:NDIKUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:9757 GOOD LUCK RD APT 4
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3327
Mailing Address - Country:US
Mailing Address - Phone:240-354-5994
Mailing Address - Fax:
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE STE B130
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:301-494-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist