Individual
NELSON BONGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1930 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7006
(202) 450-5822
Mailing address
1930 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7006
(202) 450-5822
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
06/14/2012
Last updated
06/12/2024
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