Healthcare Provider Details

I. General information

NPI: 1215582978
Provider Name (Legal Business Name): HOWARD UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 BENNING RD NE FL 2
WASHINGTON DC
20019-4555
US

IV. Provider business mailing address

2041 GEORGIA AVE NW STE 6101
WASHINGTON DC
20060-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-2120
  • Fax: 202-396-2030
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERTA ODINDO
Title or Position: PROVIDER ENROLLMENT MANAGER
Credential:
Phone: 202-865-6679