Individual
DR. MARTIN TANWIE FONJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11114 POMPEY DR, UPPER MARLBORO, MD 20772-4859
(240) 604-6481
Mailing address
11114 POMPEY DR, UPPER MARLBORO, MD 20772-4859
(240) 604-6481
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F525585785427
—
MD
Enumeration date
08/05/2021
Last updated
08/05/2021
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