Provider Demographics
NPI:1255706859
Name:DJIKEGOUE, PHILIPPE NGADJUI
Entity type:Individual
Prefix:MR
First Name:PHILIPPE
Middle Name:NGADJUI
Last Name:DJIKEGOUE
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 1:6650 GEORGIA AVE NW
Mailing Address - Street 2:104
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2546
Mailing Address - Country:US
Mailing Address - Phone:202-243-9162
Mailing Address - Fax:
Practice Address - Street 1:6650 GEORGIA AVE NW
Practice Address - Street 2:104
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2546
Practice Address - Country:US
Practice Address - Phone:202-243-9162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11611374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide