Individual
MR. FREDERICK CHUMFONG MBIATAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4645 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-3622
(202) 733-4904
Mailing address
4645 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-3622
(202) 733-4904
(202) 733-4879
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN50002044
DC
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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