MEDICARE: ADESUWA EJEHI ABULU

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	374U00000X	Home Health Aide	HHA200002596	DC
2	3747P1801X	Personal Care Attendant	HHA200002596	DC
3	376K00000X	Nurse's Aide	A00177833	MD

General Provider Information

NPI Number	:	1063027027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADESUWA EJEHI ABULU

Provider Business Mailing Address
First Line	:	3310 PARKFORD MANOR TER APT L
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-6146
Country	:	US
Telephone Number	:	404-477-8534
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 S ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-6925
Country	:	US
Telephone Number	:	202-538-1910
Fax Number	:

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

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	05/27/2026

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Directions to “ ADESUWA EJEHI ABULU ” Practice Location

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