Individual
ANANGA ISAAC FOMINYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4806 WILLES VISION DR, BOWIE, MD 20720-4671
(512) 797-4871
Mailing address
4806 WILLES VISION DR, BOWIE, MD 20720-4671
(512) 797-4871
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
186626
MD
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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