| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BERTRAND NKAFU ANDUKWA EBUNJI | 1629721667 | 2022-01-31 |
Bertrand Nkafu Andukwa Ebunji is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1629721667. Registration indicates Bertrand Nkafu Andukwa Ebunji is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, General Practice Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) (Allopathic & Osteopathic Physicians, General Practice) (General Practice, ) (Primary Care/Family Planning/APRN/PA, ) (General Practice, Allopathic & Osteopathic Physicians) (Other Service Providers, Military Health Care Provider) (Military Health Care Provider, ) (Military Health Care Provider, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Dr. Bertrand Nkafu Andukwa Ebunji MD |
| Practice Office Address | 47149 BUSE RD BLDG 1370 PATUXENT RIVER, MD US |
| Practice Office Telephone | 3013420029 |
| Practice Office Fax | 3013424054 |
| Mailing Address | 47149 BUSE RD BLDG 1370 PATUXENT RIVER, MD 206701540 US |
| Code | Practice | License No State |
|---|---|---|
| 208D00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians General PracticeAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians General Practice Allopathic & Osteopathic Physicians General Practice General Practice Primary Care/Family Planning/APRN/PA General Practice Allopathic & Osteopathic Physicians | 0101279747
VA |
| 171000000X | Other Service Providers Military Health Care Provider Military Health Care Provider Military Health Care Provider Other Service Providers |