Provider Demographics
NPI:1932615747
Name:KALEMBO, LUYANDO
Entity Type:Individual
Prefix:
First Name:LUYANDO
Middle Name:
Last Name:KALEMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4709 S OXBOW AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4106
Mailing Address - Country:US
Mailing Address - Phone:605-838-5827
Mailing Address - Fax:
Practice Address - Street 1:4709 S OXBOW AVE
Practice Address - Street 2:120
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-5710
Practice Address - Country:US
Practice Address - Phone:605-838-5827
Practice Address - Fax:605-838-5827
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD208G00000X208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)