Basic Information
Provider Information
NPI: 1861536237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKOTO
FirstName: KWAME
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 2101 E JEFFERSON ST
Address2: KAISER PERMANENTE MEDICARE ENROLLMENT
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 12201 PLUM ORCHARD DR
Address2:  
City: SILVER SPRING
State: MD
PostalCode: 209047803
CountryCode: US
TelephoneNumber: 3015721000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/17/2007
LastUpdateDate: 07/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XD68799MDY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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