Individual
MR. THEOPHILUS IKECHUKWU NDUKWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6856 EASTERN AVE NW STE 220, WASHINGTON, DC 20012-2166
(202) 291-6973
Mailing address
6938 DECATUR ST, HYATTSVILLE, MD 20784-1547
(301) 583-0007
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN1002477
DC
376K00000X
Nurse's Aide
Primary
LPN1002477
DC
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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