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1679234371
IVAN CHE NDAMUKONG
PORTSMOUTH, VA
NPI
1679234371
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110008765)
Enumeration Date
2022-01-04
Last Update Date
2022-08-29
Business Address
IVAN CHE NDAMUKONG PhD, PA-C
1040 UNIVERSITY BLVD STE 205
PORTSMOUTH, VA 23703-2650
Phone number: 757-391-7370
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Mailing Address
IVAN CHE NDAMUKONG PhD, PA-C
2113 CHESTERFIELD LOOP
CHESAPEAKE, VA 23323-6670
Phone number: 252-412-9548
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