Individual
GORDEN FON KEM BUMBARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 FOX ST, ADELPHI, MD 20783-2359
(240) 476-9815
Mailing address
1906 FOX ST, ADELPHI, MD 20783-2359
(240) 476-9815
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
HHA13955
DC
Other
Enumeration date
09/17/2018
Last updated
08/04/2023
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