Provider Demographics
NPI:1902344278
Name:NEH-LUM, CHI
Entity Type:Individual
Prefix:MR
First Name:CHI
Middle Name:
Last Name:NEH-LUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 TALLYRAND TRL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6943
Mailing Address - Country:US
Mailing Address - Phone:443-255-5992
Mailing Address - Fax:
Practice Address - Street 1:14601 TALLYRAND TRL
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6943
Practice Address - Country:US
Practice Address - Phone:443-255-5992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1043124163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse