Healthcare Provider Details

I. General information

NPI: 1023466950
Provider Name (Legal Business Name): EUGENE KOJO OTENG M.D., PH. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOWARD UNIVERISTY HOSPITAL 2041 GEORGIA AVE NW,
WASHINGTON DC
20059
US

IV. Provider business mailing address

11101 GEORGIA AVE UNIT 448
SILVER SPRING MD
20902-7618
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-6100
  • Fax:
Mailing address:
  • Phone: 571-276-9037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1255
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD24774
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.136555
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.136555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: