Provider Demographics
NPI:1821813387
Name:NGAM AYEAH, KENNETH NGONG
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:NGONG
Last Name:NGAM AYEAH
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 1:702 15TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4508
Mailing Address - Country:US
Mailing Address - Phone:202-388-8500
Mailing Address - Fax:
Practice Address - Street 1:5251 EARLES CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2820
Practice Address - Country:US
Practice Address - Phone:240-491-6774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker