MEDICARE: PRIDE AKAMDAWOH SAMJELLA

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	171M00000X	Case Manager/Care Coordinator
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1275341018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIDE AKAMDAWOH SAMJELLA

Provider Business Mailing Address
First Line	:	5910 UPPER CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5407
Country	:	US
Telephone Number	:	301-531-0091
Fax Number	:

Provider Business Practice Location Address
First Line	:	5910 UPPER CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-5407
Country	:	US
Telephone Number	:	301-531-0091
Fax Number	:

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

Provider Enumeration Date	:	12/26/2024
Last Update Date	:	01/03/2026

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Directions to “ PRIDE AKAMDAWOH SAMJELLA ” Practice Location

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