MEDICARE: DOROTHY ADEJOKE EHIKHAMELE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1376321695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY ADEJOKE EHIKHAMELE

Provider Business Mailing Address
First Line	:	11122 SOUTHLAKES DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-1801
Country	:	US
Telephone Number	:	240-906-4717
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 MARTIN LUTHER KING JR AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-7024
Country	:	US
Telephone Number	:	202-547-8450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2023
Last Update Date	:	06/11/2026

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