Individual
MILTON FONGANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3211 75TH AVE APT 102, LANDOVER, MD 20785-1932
(240) 424-1390
Mailing address
3211 75TH AVE APT 102, LANDOVER, MD 20785-1932
(240) 424-1390
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA15467
MD
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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