MEDICARE: REMY EBUNG EKANEWANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1013271261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REMY EBUNG EKANEWANG

Provider Business Mailing Address
First Line	:	14009 BRAMBLE LN APT T2
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1222
Country	:	US
Telephone Number	:	240-440-0433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 NEW YORK AVE NE STE 110
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1849
Country	:	US
Telephone Number	:	202-489-0615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	10/01/2024

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Directions to “ REMY EBUNG EKANEWANG ” Practice Location

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