Individual
BRYAN FOAGUEGUE ATEBA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
481 BRUCE AVE, ODENTON, MD 21113-1926
(202) 876-8494
Mailing address
481 BRUCE AVE, ODENTON, MD 21113-1926
(202) 876-8494
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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