Provider Demographics
NPI:1962154989
Name:SHAMAMBO, LUWI JOY
Entity type:Individual
Prefix:
First Name:LUWI
Middle Name:JOY
Last Name:SHAMAMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 LINDBERGH PL NE APT 609
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3336
Mailing Address - Country:US
Mailing Address - Phone:615-719-0059
Mailing Address - Fax:
Practice Address - Street 1:100 WOODRUFF CIRCLE ATLANTA
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-727-2931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program