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Individual

LUCAS MBAKWA FONCHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
780 FAIRVIEW AVE APT 605, TAKOMA PARK, MD 20912-5951
(202) 779-2523
Mailing address
780 FAIRVIEW AVE APT 605, TAKOMA PARK, MD 20912-5951

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
376K00000X
Nurse's Aide
Primary
MD

Other

Enumeration date
10/02/2021
Last updated
03/17/2026
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