Healthcare Provider Details

I. General information

NPI: 1528859543
Provider Name (Legal Business Name): ROLLIN EMERY YIMGA WANDJI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-6900
US

IV. Provider business mailing address

1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-6900
US

V. Phone/Fax

Practice location:
  • Phone: 202-442-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: