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NPI Code Detail

MEDICARE: MR. KOFI GRAHAM

MEDICARE: MR. KOFI GRAHAM
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1770416588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KOFI GRAHAM
Provider Business Mailing Address
First Line : 606 TEWKESBURY PL NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20012-2634
Country : US
Telephone Number : 202-258-9100
Fax Number :
Provider Business Practice Location Address
First Line : 210 55TH ST NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-6784
Country : US
Telephone Number : 202-559-2477
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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