Provider Demographics
NPI:1679965651
Name:AHMADU, MOIMUSA (ATC)
Entity type:Individual
Prefix:MR
First Name:MOIMUSA
Middle Name:
Last Name:AHMADU
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 UTAH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2436
Mailing Address - Country:US
Mailing Address - Phone:202-609-2428
Mailing Address - Fax:
Practice Address - Street 1:1230 31ST ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-3400
Practice Address - Country:US
Practice Address - Phone:202-609-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer