Provider Demographics
NPI:1104463215
Name:NGUNDE, GODLOVE NGUNDE (GODLOVE)
Entity type:Individual
Prefix:
First Name:GODLOVE
Middle Name:NGUNDE
Last Name:NGUNDE
Suffix:
Gender:M
Credentials:GODLOVE
Other - Prefix:DR
Other - First Name:GODLOVE
Other - Middle Name:NGUNDE
Other - Last Name:NGUNDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2507 DUNROBIN DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2898
Mailing Address - Country:US
Mailing Address - Phone:240-277-9268
Mailing Address - Fax:
Practice Address - Street 1:2507 DUNROBIN DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2898
Practice Address - Country:US
Practice Address - Phone:240-277-9268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist