MEDICARE: DORA ANTWI

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144934860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORA ANTWI

Provider Business Mailing Address
First Line	:	2690 PENBURY CT APT 302
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-4238
Country	:	US
Telephone Number	:	571-866-0105
Fax Number	:

Provider Business Practice Location Address
First Line	:	2046 RICHMOND HWY STE A
Second Line	:
City	:	STAFFORD
State	:	VA
Zip	:	22554-7276
Country	:	US
Telephone Number	:	202-604-1610
Fax Number	:	808-466-1211

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

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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Directions to “ DORA ANTWI ” Practice Location

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