Individual
DIVINE AMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1716 E BROAD ST, STATESVILLE, NC 28625-4306
(704) 872-8131
Mailing address
1503 DICKENS PL, UPPER MARLBORO, MD 20774-6037
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
34155
NC
Other
Enumeration date
09/18/2025
Last updated
10/24/2025
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