Individual
AMONGWA FOBANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9127 EDMONSTON TER, GREENBELT, MD 20770-1543
(240) 264-9129
Mailing address
9127 EDMONSTON TER, GREENBELT, MD 20770-1543
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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