Provider Demographics
NPI:1497299291
Name:HEMOU, JEAN CLAUDE
Entity Type:Individual
Prefix:
First Name:JEAN CLAUDE
Middle Name:
Last Name:HEMOU
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 METZEROTT RD APT 56
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5123
Mailing Address - Country:US
Mailing Address - Phone:240-486-7591
Mailing Address - Fax:
Practice Address - Street 1:1808 METZEROTT RD APT 56
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-5123
Practice Address - Country:US
Practice Address - Phone:240-486-7591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12489374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide