Individual
MANDOP MARILYN FONKENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1290 E WEST HWY, SILVER SPRING, MD 20910-3242
(301) 588-6261
Mailing address
1103 BURKETON RD, HYATTSVILLE, MD 20783-3002
(678) 346-1149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25483
MD
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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