Individual
MICAH FORKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9741 GOOD LUCK RD APT 10, LANHAM, MD 20706-3320
(774) 204-2665
Mailing address
9741 GOOD LUCK RD APT 10, LANHAM, MD 20706-3320
(774) 204-2665
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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