Individual
DIVINE AMADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4530 WISCONSIN AVE NW, WASHINGTON, DC 20016-4627
(202) 536-4414
Mailing address
3350 TOLEDO TER APT 264, HYATTSVILLE, MD 20782-1396
(202) 905-2537
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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