Individual
MICAH ELEZUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(202) 388-8500
Mailing address
8662 BRAE BROOKE DR, LANHAM, MD 20706-3814
(202) 430-8440
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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