Healthcare Provider Details

I. General information

NPI: 1477184117
Provider Name (Legal Business Name): ADELIA DUALA NDIKUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9977 GOOD LUCK RD APT 201
LANHAM MD
20706-3281
US

IV. Provider business mailing address

6323 GEORGIA AVE NW STE 305
WASHINGTON DC
20011-1141
US

V. Phone/Fax

Practice location:
  • Phone: 240-610-3033
  • Fax:
Mailing address:
  • Phone: 202-506-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA14957
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: