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Individual

MR. DIVINE NDEMAZEH KUNGANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4130 HUNT PL NE, WASHINGTON, DC 20019-3565
(202) 388-4300
(202) 388-4339
Mailing address
6505 MANTON WAY, LANHAM, MD 20706-2488
(240) 906-4174

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN500021398
DC
172V00000X
Community Health Worker
Primary

Other

Enumeration date
02/01/2021
Last updated
01/12/2026
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