Individual
EMMANUEL FONDONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3805 ELMCREST LN, BOWIE, MD 20716-7358
(540) 497-1627
Mailing address
3805 ELMCREST LN, BOWIE, MD 20716-7358
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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