Individual provider · Type 1 NPI
Monick Fanba
Medical Physician Assistant · Upper Marlboro, MD
NPI number
1093196990
Active
Practice location
2502 Moores Plains Blvd
Upper Marlboro, MD 20774-8027
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | C0005761 (MD) |
Medical Physician Assistant: Definition to come...
About NPI 1093196990
Monick Fanba's National Provider Identifier is 1093196990, issued on Jun 16, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Upper Marlboro, MD. The record was last updated on Jun 16, 2015.