Willie B Mvemba

Primary specialty

SpecialistTaxonomy code 174400000X

License

D0055425 Issued in MD

Practice address

413 Commonwealth Ave
Suite 3
Catonsville, MD 21228-3044

Phone

(410) 719-0020

Fax

(410) 744-6755

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1790757326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 WASHINGTON AVE",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212443776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 COMMONWEALTH AVE",
            "address_2": "SUITE 3",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212283044",
            "telephone_number": "410-719-0020",
            "fax_number": "410-744-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MVEMBA",
        "first_name": "WILLIE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0055425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.