Provider Demographics
NPI:1922840206
Name:FULU, FREDERICK ASONGYEN
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:ASONGYEN
Last Name:FULU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8409 FIELDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4767
Mailing Address - Country:US
Mailing Address - Phone:240-940-8670
Mailing Address - Fax:
Practice Address - Street 1:8409 FIELDSTONE WAY
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4767
Practice Address - Country:US
Practice Address - Phone:240-940-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator