Provider Demographics
NPI:1194587519
Name:CHINGKALA, CLAUVERT SANGU
Entity type:Individual
Prefix:
First Name:CLAUVERT
Middle Name:SANGU
Last Name:CHINGKALA
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 1:4311 HAVELOCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1940
Mailing Address - Country:US
Mailing Address - Phone:240-467-6224
Mailing Address - Fax:
Practice Address - Street 1:4311 HAVELOCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1940
Practice Address - Country:US
Practice Address - Phone:240-467-6224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide