Individual
FORTUCHANG PETER MBOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7777 RIVERDALE RD, APT 102, NEW CARROLLTON, MD 20784-3937
(301) 755-8689
Mailing address
7777 RIVERDALE RD, APT 102, NEW CARROLLTON, MD 20784-3937
(301) 755-8689
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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