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Individual

DAVID NDIKUM MOFFOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP, CRNA

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 853-0222
(540) 981-7855
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5372

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001268324
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024184367
VA
367500000X
Certified Registered Nurse Anesthetist
137560
VA

Other

Enumeration date
05/11/2022
Last updated
03/13/2026
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