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General NPI Number Information
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NPI Number | 1235579723
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Entity Type | Organization
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Legal Business Name | DIKE UZOUKWU
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 5421 LAKEFORD LN
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City | BOWIE
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State | MD
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Zip | 20720-4855
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Country | US
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Telephone | 240-486-9086
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Fax | 301-794-4420
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Provider Business Mailing Address
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Address Line | 5421 LAKEFORD LN
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City | BOWIE
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State | MD
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Zip | 20720-4855
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Country | US
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Telephone | 240-486-9086
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Fax | 301-794-4420
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DIKE UZOUKWU
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Credential |
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Telephone | 240-486-9086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | DC
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