Provider Information for 1720506900
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KUMI PLEDGER
Sex: Female
NPI: 1720506900
Last Updated: 2018-03-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1720506900 | ||||||||
| Enumeration Date | 2017-09-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 431 SEAGULL LN LUSBY, MD 20657-4135 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 431 SEAGULL LN LUSBY, MD 20657-4135 United States Phone: 443-489-6463 | Fax: | ||||||||
| Secondary Practice Address(es) | 4475 REGENCY PL 4475 REGENCY PL STE 205 | ||||||||
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