Healthcare Provider Details

I. General information

NPI: 1043142920
Provider Name (Legal Business Name): CHARLIE ACHU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

IV. Provider business mailing address

5601 OLIVIA CT
BOWIE MD
20720-4903
US

V. Phone/Fax

Practice location:
  • Phone: 240-825-6746
  • Fax:
Mailing address:
  • Phone: 240-825-6746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: