Healthcare Provider Details

I. General information

NPI: 1205745189
Provider Name (Legal Business Name): YVES ROLAND NDANGA YONKEU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-4318
US

IV. Provider business mailing address

8468 IMPERIAL DR
LAUREL MD
20708-1836
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-0742
  • Fax:
Mailing address:
  • Phone: 240-413-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: