Provider Demographics
NPI:1326308289
Name:ATABONG, AWUNGFUET MARGARET (HOME HEALTH AID)
Entity Type:Individual
Prefix:
First Name:AWUNGFUET
Middle Name:MARGARET
Last Name:ATABONG
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 BREEZEWOOD DR APT 103
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4112
Mailing Address - Country:US
Mailing Address - Phone:202-706-1138
Mailing Address - Fax:
Practice Address - Street 1:1907 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4683
Practice Address - Country:US
Practice Address - Phone:202-735-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD522287709163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health