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1548979107
ABDUL MALIK FOFANAH
BALTIMORE, MD
NPI
1548979107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MD R215797)
Enumeration Date
2022-11-22
Last Update Date
2024-06-06
Business Address
ABDUL MALIK FOFANAH NP
2115 N CHARLES ST
BALTIMORE, MD 21218-5760
Phone number: 240-441-7536
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Mailing Address
ABDUL MALIK FOFANAH NP
2115 N CHARLES ST
BALTIMORE, MD 21218-5760
Phone number: 240-441-7536
Copy
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