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NPI Code Detail

MEDICARE: POLYCARP N TEBOH

MEDICARE: POLYCARP N TEBOH
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
1374U00000XHome Health AideHHA200003947DC

General Provider Information

NPI Number : 1699514323
Entity Type Code : Individual
Provider Name (Legal Business Name) : POLYCARP N TEBOH
Provider Business Mailing Address
First Line : 4660 MARTIN LUTHER KING JR AVE SW
Second Line :
City : WASHINGTON
State : DC
Zip : 20032-4933
Country : US
Telephone Number : 240-726-9543
Fax Number :
Provider Business Practice Location Address
First Line : 2512 24TH ST NE # E
Second Line :
City : WASHINGTON
State : DC
Zip : 20018-2126
Country : US
Telephone Number : 202-832-8340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2024
Last Update Date : 06/10/2026

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Directions to “ POLYCARP N TEBOH ” Practice Location

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