Individual
CEDRIC WABILA GWANFOGBE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOLE PROPRIETOR
Contact information
Practice address
2501 MARION BARRY AVE SE, WASHINGTON, DC 20020-3011
(202) 441-2501
Mailing address
1317 KINGSBURY DR WOODMORE, BOWIE, MD 20721-1200
(240) 722-2267
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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