Provider Demographics
NPI:1982994257
Name:MBUGUA, DAVID NDIRANGU
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:NDIRANGU
Last Name:MBUGUA
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 1:239 SAINT CHRISTOPHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1815
Mailing Address - Country:US
Mailing Address - Phone:253-414-2148
Mailing Address - Fax:
Practice Address - Street 1:239 SAINT CHRISTOPHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1815
Practice Address - Country:US
Practice Address - Phone:253-414-2148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138776164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse