Provider Demographics
NPI:1073911723
Name:NGATCHOU, THEODORE
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:
Last Name:NGATCHOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 QUACKENBOS ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1652
Mailing Address - Country:US
Mailing Address - Phone:202-262-3610
Mailing Address - Fax:202-526-1230
Practice Address - Street 1:6323 GEORGIA AVE NW STE 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1101
Practice Address - Country:US
Practice Address - Phone:202-609-9796
Practice Address - Fax:202-526-1230
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider