Provider Demographics
NPI:1295400075
Name:AKUM, ANZERIBIAM YVONNE (MS,RDN, LDN)
Entity Type:Individual
Prefix:
First Name:ANZERIBIAM
Middle Name:YVONNE
Last Name:AKUM
Suffix:
Gender:F
Credentials:MS,RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 CONNECTICUT AVE NW STE 251
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2651
Mailing Address - Country:US
Mailing Address - Phone:240-722-1014
Mailing Address - Fax:
Practice Address - Street 1:2639 CONNECTICUT AVE NW STE 251
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2651
Practice Address - Country:US
Practice Address - Phone:240-722-1014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3698133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered