Provider Demographics
NPI:1306435987
Name:MUHORO, GITAU DAVID
Entity type:Individual
Prefix:MR
First Name:GITAU
Middle Name:DAVID
Last Name:MUHORO
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 1:74 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-6912
Mailing Address - Country:US
Mailing Address - Phone:434-444-0842
Mailing Address - Fax:
Practice Address - Street 1:2434 KEMPER ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-4030
Practice Address - Country:US
Practice Address - Phone:434-444-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401069625376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide