Dimeji Taofeek Agboke, HHA

Individual provider Active NPI Home Health Aide · Upper Marlboro, MD

NPI 1992056691 · NPPES record last updated Sep 21, 2012

Key facts

NPI
1992056691
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
1007 Butterworth LN
Upper Marlboro, MD 20774-2204
Phone
(202) 545-0935
Fax
(202) 545-0176
NPI assigned
Sep 21, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Yes

Addresses

Primary practice location

1007 Butterworth LN
Upper Marlboro, MD 20774-2204

Mailing address

1007 Butterworth LN
Upper Marlboro, MD 20774-2204
Phone (202) 545-0935

Other providers in Upper Marlboro, MD

All providers in Upper Marlboro, MD · Home Health Aide in Maryland

Sources for this page

Verify at the official NPI Registry.