Provider Demographics
NPI:1942927595
Name:NKEMTITAH, DAVID TAKU
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:TAKU
Last Name:NKEMTITAH
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 1:350 EASTERN AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2833
Mailing Address - Country:US
Mailing Address - Phone:202-248-1356
Mailing Address - Fax:
Practice Address - Street 1:2027 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7007
Practice Address - Country:US
Practice Address - Phone:202-506-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health