| Celebra Med Llc | |
|
101 W Ridgely Rd Ste 8a Lutherville MD 21093-5124 | |
| (443) 356-1494 | |
| Not Available |
| Full Name | Celebra Med Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 W Ridgely Rd Ste 8a, Lutherville, Maryland |
| Authorized Official Name and Position | Herman Ndungu (OWNER) |
| Authorized Official Contact | 4433561494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Celebra Med Llc 2803 Todkill Trce Edgewood MD 21040-3430 Ph: () - | Celebra Med Llc 101 W Ridgely Rd Ste 8a Lutherville MD 21093-5124 Ph: (443) 356-1494 |
| NPI Number | 1225662968 |
|---|---|
| Provider Enumeration Date | 03/02/2020 |
| Last Update Date | 03/02/2020 |
| Certification Date | 03/02/2020 |
| Medicare PECOS PAC ID | 0446674360 |
|---|---|
| Medicare Enrollment ID | O20200723002525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225662968 | NPI | - | NPPES |
| Provider Name | Herman K Ndungu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992345714 PECOS PAC ID: 1355765272 Enrollment ID: I20200724000801 |
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