Provider Demographics
NPI:1336963289
Name:EKHAESOMHI, PRAISE-GOD
Entity type:Individual
Prefix:
First Name:PRAISE-GOD
Middle Name:
Last Name:EKHAESOMHI
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 1:7256 W HARTFORD CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5518
Mailing Address - Country:US
Mailing Address - Phone:404-610-7650
Mailing Address - Fax:
Practice Address - Street 1:230 NORTHLAND BLVD STE 216
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3752
Practice Address - Country:US
Practice Address - Phone:404-610-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health