# CHARLES FONGOH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1073284808
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 376K00000X | Nurse's Aide | A00197241 | MD | — |

## Other

- **Enumeration date:** 09/22/2021
- **Last updated:** 08/08/2024