Healthcare Provider Details

I. General information

NPI: 1659285666
Provider Name (Legal Business Name): JOHN IWEMJIWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PA AVE SE STE 210
WASHINGTON DC
20003-4344
US

IV. Provider business mailing address

9109 SPRING WAY
UPPER MARLBORO MD
20774-3536
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax:
Mailing address:
  • Phone: 202-282-3004
  • Fax: 202-282-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200005912
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: