Mohamed Bundu
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Washington, DC
NPI 1376917385 · NPPES record last updated Jan 13, 2020
Key facts
- NPI
- 1376917385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 174442 (MD)
- Practice address
- 50 Irving St NW
Washington, DC 20422-3317 - Phone
- (202) 745-8695
- NPI assigned
- Nov 15, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174442 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | R174442 | MD | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 174442 | MD | Yes |
Addresses
Primary practice location
50 Irving St NW
Washington, DC 20422-3317
Mailing address
2602 Rose Mount LN
Bowie, MD 20721-1878
Phone (301) 808-4264
Other practice location 1
200 I St SE
Washington, DC 20003-3317
Phone (202) 484-6242
Other practice location 2
1000 Mt Olivet Rd NE
Washington, DC 20002-2210
Phone (202) 576-8388
Other providers in Washington, DC
- Bumed
- Elizabeth Bumpas
- Abie A Bundu Sama
- Fatima Mariama Bundu-Kargbo
- Abibatu Bundu
- Camille Bundy
- Kamille Bundy
- Vanessa Bundy
- Brunhilda Yedmia Bungwa
- Kehbuma Bungwa
All providers in Washington, DC · Psychiatric/Mental Health Nurse Practitioner in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.