Individual
MARTIN FOBUH MBANONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 ASTRID CT, BROOKEVILLE, MD 20833-3254
(301) 860-7833
Mailing address
2400 ASTRID CT, BROOKEVILLE, MD 20833-3254
(301) 860-7833
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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