Provider Demographics
NPI:1801141817
Name:AMEGEE, KOFFI HIHEWADO
Entity type:Individual
Prefix:MR
First Name:KOFFI
Middle Name:HIHEWADO
Last Name:AMEGEE
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 1:820 UPSHUR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5837
Mailing Address - Country:US
Mailing Address - Phone:202-723-0304
Mailing Address - Fax:202-723-0367
Practice Address - Street 1:820 UPSHUR ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5837
Practice Address - Country:US
Practice Address - Phone:202-723-0304
Practice Address - Fax:202-723-0367
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide