Provider Demographics
NPI:1083502447
Name:AKONGHA, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:AKONGHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:AKONGHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8828 HUNTING LN APT 104
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1273
Mailing Address - Country:US
Mailing Address - Phone:240-604-6284
Mailing Address - Fax:240-604-6284
Practice Address - Street 1:8828 HUNTING LN APT 104
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1273
Practice Address - Country:US
Practice Address - Phone:240-604-6284
Practice Address - Fax:240-604-6284
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator