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General NPI Number Information
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NPI Number | 1750923116
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Entity Type | Individual
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Provider Name | SIMON NKWELLE AKANDE
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Gender | Male
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 5513 ILLINOIS AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20011-2937
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Country | US
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Telephone | 202-882-9310
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 W FOREST RD APT 202
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City | LANDOVER
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State | MD
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Zip | 20785-3308
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Country | US
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Telephone | 240-906-7906
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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 | HHA14692
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License Number State | DC
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