Provider Demographics
NPI:1083106108
Name:EKOKOBE, ATABONGNKENG
Entity Type:Individual
Prefix:
First Name:ATABONGNKENG
Middle Name:
Last Name:EKOKOBE
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 1:5115 CHESHIRE LN # 204
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4165
Mailing Address - Country:US
Mailing Address - Phone:240-643-5861
Mailing Address - Fax:
Practice Address - Street 1:5115 CHESHIRE LN # 204
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4165
Practice Address - Country:US
Practice Address - Phone:240-643-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide