Healthcare Provider Details

I. General information

NPI: 1932809894
Provider Name (Legal Business Name): MR. KWAKU A ATTAKORA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-5732
US

IV. Provider business mailing address

9900 RODIN CT
UPPER MARLBORO MD
20772-4802
US

V. Phone/Fax

Practice location:
  • Phone: 202-563-7632
  • Fax:
Mailing address:
  • Phone: 202-480-0260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: