Individual
THERESIA DIMIA FOFUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1508 E CAPITOL ST NE, WASHINGTON, DC 20003-1507
(202) 371-9393
(202) 697-5069
Mailing address
14804 ASHFORD PL, LAUREL, MD 20707-3770
(301) 270-7089
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN1056507
DC
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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