Provider Demographics
NPI:1144075912
Name:TEKE, GHISLAIN MBA III
Entity type:Individual
Prefix:
First Name:GHISLAIN
Middle Name:MBA
Last Name:TEKE
Suffix:III
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 1:100 JEFFERSON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6628
Mailing Address - Country:US
Mailing Address - Phone:202-931-8546
Mailing Address - Fax:
Practice Address - Street 1:100 JEFFERSON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6628
Practice Address - Country:US
Practice Address - Phone:202-931-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator