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General NPI Number Information
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NPI Number | 1235640475
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Entity Type | Individual
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Provider Name | KINGSLEY AWAH
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Gender | Male
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 7932 DUNHILL VILLAGE CIR
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City | WINDSOR MILL, BALTIMORE
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State | MD
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Zip | 21244
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Country | US
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Telephone | 213-273-6529
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Fax | 213-273-6529
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Provider Business Mailing Address
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Address Line | 7932 DUNHILL VILLAGE CIR APT 201
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City | WINDSOR MILL
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State | MD
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Zip | 21244-4104
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA13012
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License Number State | DC
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