Healthcare Provider Details

I. General information

NPI: 1225475205
Provider Name (Legal Business Name): PAUL KEMAKOLAM ANOKAM HHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL KEMAKOLAM ANOKAM HHA

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 HORNBEAM CT
GLENARDEN MD
20706-5516
US

IV. Provider business mailing address

5615 ELLERBIE ST
LANHAM MD
20706-2429
US

V. Phone/Fax

Practice location:
  • Phone: 240-513-0873
  • Fax:
Mailing address:
  • Phone: 240-305-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA5971
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: