Individual
MUDOH LAMBERT FONGANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2811 PENNSYLVANIA AVE SE, WASHINGTON, DC 20020-3865
(202) 894-6811
Mailing address
2907 LAKE FOREST DR, UPPER MARLBORO, MD 20774-8972
(240) 486-5785
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
09/29/2015
Last updated
07/07/2023
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