Provider Demographics
NPI:1063144673
Name:NJIWAJI, NWANA MICHAEL
Entity type:Individual
Prefix:
First Name:NWANA
Middle Name:MICHAEL
Last Name:NJIWAJI
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 1:7857 RIVERDALE RD APT 203
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-4027
Mailing Address - Country:US
Mailing Address - Phone:240-610-7204
Mailing Address - Fax:
Practice Address - Street 1:7857 RIVERDALE RD APT 203
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-4027
Practice Address - Country:US
Practice Address - Phone:240-610-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200001929374U00000X
DC172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCHHA20001929OtherHOME HEALTH AIDE