Provider Demographics
NPI:1447611322
Name:YANKAM, OJONG
Entity Type:Individual
Prefix:
First Name:OJONG
Middle Name:
Last Name:YANKAM
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 1:1808 GREENWICH WOOD DR
Mailing Address - Street 2:APT. 13
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-2113
Mailing Address - Country:US
Mailing Address - Phone:301-792-0860
Mailing Address - Fax:
Practice Address - Street 1:1808 GREENWICH WOOD DR
Practice Address - Street 2:APT. 13
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-2113
Practice Address - Country:US
Practice Address - Phone:301-792-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11927374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide