Individual
ADA A. KAGUMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1118 HAMPSHIRE ST, QUINCY, IL 62301-3027
(217) 222-6550
Mailing address
1025 MAINE ST., QUINCY, IL 62301
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036106906
IL
207V00000X
Obstetrics & Gynecology Physician
072381
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I163207
MEDICARE PTAN
GA
Enumeration date
02/08/2006
Last updated
09/23/2016
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