Individual
MR. CALEB FORKWA FOMBEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6511 WOODSTREAM DR, MD 20706, LANHAM, MD 20706-2119
(240) 705-4053
Mailing address
6511 WOODSTREAM DR, MD 20706, LANHAM, MD 20706-2119
(240) 705-4053
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA6571
WA
374U00000X
Home Health Aide
HHA6571
WA
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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