Individual
MR. FONCHAM BUMA FONCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
856 UNIVERSITY AVENUE, W, ST. PAUL, MN 55104
(651) 665-9795
(651) 665-9796
Mailing address
856 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4807
(651) 665-9795
(651) 665-9796
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2456955
MN
Other
Enumeration date
09/29/2017
Last updated
07/21/2022
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