Provider Demographics
NPI:1104187038
Name:SEWODJI, NADEGE
Entity Type:Individual
Prefix:
First Name:NADEGE
Middle Name:
Last Name:SEWODJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8521 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3027
Mailing Address - Country:US
Mailing Address - Phone:202-903-1558
Mailing Address - Fax:202-722-7785
Practice Address - Street 1:2515 ALABAMA AVE SE APT 306
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3245
Practice Address - Country:US
Practice Address - Phone:949-307-7637
Practice Address - Fax:202-722-7785
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
DC11041870383747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide