Bongutu, Mbembo

Bongutu, Mbembo is an individual health care provider with primary practice located at 201 State St , Erie PA 16550-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bongutu, Mbembo can be contacted via phone (814) 877-4922.

Contact Information

Primary practice address
201 State St Erie PA 16550-0002
Phone: (814) 877-4922
Fax: (814) 877-3622
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD062832L Pennsylvania

Profile Details

NPI number 1851393268
LBN Legal business name Bongutu, Mbembo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Apr 26th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851393268 NPPES
Pennsylvania Other P001411 GATEWAY
Pennsylvania Other 00026887601 GATEWAY
Pennsylvania Other 01983279 GATEWAY
Pennsylvania Other 75913 GATEWAY
Pennsylvania Other 080163990 GATEWAY
Pennsylvania Other 323780 GATEWAY
Pennsylvania Other 1645032 GATEWAY
Pennsylvania Other 2228324 GATEWAY
Pennsylvania MEDICAID 0016842690006 GATEWAY
Pennsylvania Other 7441061 GATEWAY

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