Healthcare Provider Details

I. General information

NPI: 1013271261
Provider Name (Legal Business Name): REMY EBUNG EKANEWANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 NEW YORK AVE NE STE 110
WASHINGTON DC
20002-1849
US

IV. Provider business mailing address

14009 BRAMBLE LN APT T2
LAUREL MD
20708-1222
US

V. Phone/Fax

Practice location:
  • Phone: 202-489-0615
  • Fax:
Mailing address:
  • Phone: 240-440-0433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: