MEDICARE: LOH EDWIN AYEAH

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		DC

General Provider Information

NPI Number	:	1659184471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOH EDWIN AYEAH

Provider Business Mailing Address
First Line	:	1445 HOWARD RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-4406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320 BRIGHTLEA DR
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2866
Country	:	US
Telephone Number	:	240-380-4292
Fax Number	:

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

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/27/2025

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