Individual provider · NPI-1

Zainab Bundu

Nurse Practitioner, Family · Laurel, MD

NPI number1508384116

StatusActive

Last updated in NPPESOct 13, 2020

Details

NPI: 1508384116
Entity type: Individual (NPI-1)
Name: Zainab Bundu
Sex: Female
Sole proprietor: Yes
Enumeration date: Sep 4, 2017
Certification date: Oct 13, 2020
Last updated: Oct 13, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	2017018163	MD	Yes
208VP0014X	Pain Medicine, Interventional Pain Medicine	R202573	MD
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–

Practice location

135 Bowie Rd
Laurel, MD 20707-4631

Phone 240-584-1048

Mailing address

135 Bowie Rd
Laurel, MD 20707-4631

Phone 240-584-1048

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