Provider Demographics
NPI:1174883490
Name:NDUMBE, NABILA TITANJI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NABILA
Middle Name:TITANJI
Last Name:NDUMBE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2968
Mailing Address - Country:US
Mailing Address - Phone:410-496-2117
Mailing Address - Fax:410-469-5203
Practice Address - Street 1:8050 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2968
Practice Address - Country:US
Practice Address - Phone:410-496-2117
Practice Address - Fax:410-469-5203
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14309183500000X
TX46193183500000X
FLPS43451183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist