Fidele Formunyam Atum
Community Health Worker in Greenbelt, MD. Individual provider (NPI-1).
NPI number1992571749
StatusActive
Last updated in NPPESSep 17, 2024
Details
- NPI
- 1992571749
- Entity type
- Individual (NPI-1)
- Name
- Fidele Formunyam Atum
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 1, 2023
- Certification date
- Sep 17, 2024
- Last updated
- Sep 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
9138 Edmonston Ct Apt 301Greenbelt, MD 20770-4550
Phone 240-940-7977
Mailing address
9138 Edmonston Ct Apt 301Greenbelt, MD 20770-4550
Phone 240-940-7977
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