Individual
VIVIAN NDIRIKA DURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
24 MAGOTHY BEACH RD STE A, PASADENA, MD 21122-4414
(410) 255-2700
(410) 437-1962
Mailing address
7580 BUCKINGHAM BLVD STE 220, HANOVER, MD 21076-3210
(410) 729-5100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C00004666
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310866
KAISER PERMANENTE
MD
01
—
8393492
AETNA HMO
MD
01
—
9774810
AETNA PPO
MD
Enumeration date
12/29/2011
Last updated
03/22/2023
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