Healthcare Provider Details

I. General information

NPI: 1255295432
Provider Name (Legal Business Name): PETER AYUK ASHUKEM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9781 GOOD LUCK RD APT 6
LANHAM MD
20706-3339
US

IV. Provider business mailing address

9781 GOOD LUCK RD APT 6
LANHAM MD
20706-3339
US

V. Phone/Fax

Practice location:
  • Phone: 240-564-7839
  • Fax:
Mailing address:
  • Phone: 240-564-7839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: