Healthcare Provider Details

I. General information

NPI: 1033872718
Provider Name (Legal Business Name): EYERUS AKALU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW
WASHINGTON DC
20012-1324
US

IV. Provider business mailing address

6120 GEORGIA AVE NW APT 305
WASHINGTON DC
20011-5172
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-1100
  • Fax:
Mailing address:
  • Phone: 202-469-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA00198739
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: