Provider Demographics
NPI:1356770796
Name:NOVIHO, KODJO FERDINAND
Entity type:Individual
Prefix:
First Name:KODJO
Middle Name:FERDINAND
Last Name:NOVIHO
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 1:8830 PINEY BRANCH RD
Mailing Address - Street 2:APT 511
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3546
Mailing Address - Country:US
Mailing Address - Phone:240-643-1267
Mailing Address - Fax:
Practice Address - Street 1:8830 PINEY BRANCH RD
Practice Address - Street 2:APT 511
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3546
Practice Address - Country:US
Practice Address - Phone:240-643-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide