Individual
DR. DEREK FOMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7401 ANNAPOLIS RD, HYATTSVILLE, MD 20784-2313
(301) 577-7282
(301) 577-5024
Mailing address
7401 ANNAPOLIS RD, HYATTSVILLE, MD 20784-2313
(301) 577-7282
(301) 577-5024
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19842
MD
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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