Martin Tanwie Fonjong, PHD

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Practice address

11114 Pompey Dr
Upper Marlboro, MD 20772-4859

Phone

(240) 604-6481

NPI assigned

Aug 5, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1043984792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11114 POMPEY DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724859",
            "telephone_number": "240-604-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11114 POMPEY DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724859",
            "telephone_number": "240-604-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONJONG",
        "first_name": "MARTIN",
        "middle_name": "TANWIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F525585785427",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nim Fon Queenette
• Lucas Fon
• Midiana Ndum Fon
• Christabel A Fongang
• Cornelia N Fonjong
• Alexander Fonkengium
• Napthali Fonsah
• Denise Fontem
• Chanel Foote
• Mohamed I Foraida, MD

• Day Training/Habilitation Specialist in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Day Training/Habilitation Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.