Provider Demographics
NPI:1801688676
Name:GUMU, PASCAL LONTAR
Entity type:Individual
Prefix:
First Name:PASCAL
Middle Name:LONTAR
Last Name:GUMU
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 1:4032 WARNER AVE APT D1
Mailing Address - Street 2:
Mailing Address - City:LANDOVER HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1914
Mailing Address - Country:US
Mailing Address - Phone:301-851-1988
Mailing Address - Fax:
Practice Address - Street 1:4032 WARNER AVE APT D1
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1914
Practice Address - Country:US
Practice Address - Phone:301-851-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker