Individual
UNKNOWN CLAVIS FONGWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 I STREET N.W, NORTHWEST, DC 20005
(213) 317-8912
Mailing address
13817 BRIARWOOD DR # APT 1133, LAUREL, MD 20708
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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