Provider Demographics
NPI:1366254666
Name:NDUM, GODWILL ATUD JR
Entity type:Individual
Prefix:
First Name:GODWILL
Middle Name:ATUD
Last Name:NDUM
Suffix:JR
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 1:9003 BRIGHTLEA CT
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2844
Mailing Address - Country:US
Mailing Address - Phone:202-209-3746
Mailing Address - Fax:
Practice Address - Street 1:9003 BRIGHTLEA CT
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2844
Practice Address - Country:US
Practice Address - Phone:202-209-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide