Provider Demographics
NPI:1992436794
Name:CALIXTUS, ATEMNKENG
Entity type:Individual
Prefix:
First Name:ATEMNKENG
Middle Name:
Last Name:CALIXTUS
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 1:2000 TOWER OAKS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4377
Mailing Address - Country:US
Mailing Address - Phone:301-444-5001
Mailing Address - Fax:
Practice Address - Street 1:1809 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2439
Practice Address - Country:US
Practice Address - Phone:202-629-2917
Practice Address - Fax:202-629-2797
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator