Provider Demographics
NPI:1376376947
Name:NKONGJOWH, NAZARUS
Entity type:Individual
Prefix:MR
First Name:NAZARUS
Middle Name:
Last Name:NKONGJOWH
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 1:7009 GENTLE SHADE RD APT 301
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1743
Mailing Address - Country:US
Mailing Address - Phone:267-273-8253
Mailing Address - Fax:
Practice Address - Street 1:7009 GENTLE SHADE RD APT 301
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1743
Practice Address - Country:US
Practice Address - Phone:267-273-8253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator