Doctor Name: | DR. MOMPOLOKI BENSON KEALEBOGA NKHUMANE |
NPI Number: | 1144553553 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 241146 |
Business Practice Address: | 214 E 23rd St Cheyenne, WY - 820013748 |
Business Phone Number: | 3074326629 |
Business Fax Number: | 3074326634 |
Mailing Address: | Po Box 20970, CHEYENNE |
State: | WY |
Postal Code: | 820037020 |
Phone Number: | 3074326629 |
Fax Number: | 3076337676 |
NPI Enumeration Date: | 09/16/2009 |
NPI Last Update Date: | 08/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 241146 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |