Healthcare Provider Details

I. General information

NPI: 1982965810
Provider Name (Legal Business Name): ROLAND AKOH ENYIN HHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 MANOR HOUSE DR
UPPER MARLBORO MD
20774-9000
US

IV. Provider business mailing address

1010 WISCONSIN AVE. NW SUITE 300
WASHINGTON DC
20007
US

V. Phone/Fax

Practice location:
  • Phone: 240-705-1134
  • Fax:
Mailing address:
  • Phone: 240-705-1134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: