Provider Demographics
NPI:1669984621
Name:TOUANKAM, ANDREAS (HHA)
Entity type:Individual
Prefix:
First Name:ANDREAS
Middle Name:
Last Name:TOUANKAM
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 LUBBOCK RD
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-2713
Mailing Address - Country:US
Mailing Address - Phone:301-213-2046
Mailing Address - Fax:
Practice Address - Street 1:1752 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-8837
Practice Address - Country:US
Practice Address - Phone:240-408-1615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12640374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide