Individual
CRISPUS FONGOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 GOOD HOPE RD SE, WASHINGTON, DC 20020-3011
(240) 825-8561
Mailing address
4604 DICKENS PRIDE CT, BOWIE, MD 20720-5621
(240) 825-8561
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
04/14/2021
Last updated
07/21/2023
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