Individual
EMMANUEL TED MBUALUNGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
106 IRVING ST NW, SUITE 403, WASHINGTON, DC 20010-2989
(202) 291-1645
(202) 291-1062
Mailing address
14600 CEDAR KNOLL DR, CENTREVILLE, VA 20120-2895
(703) 968-2855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21791
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22932100
—
DC
Enumeration date
01/24/2007
Last updated
01/18/2012
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