Healthcare Provider Details

I. General information

NPI: 1235007675
Provider Name (Legal Business Name): FRANCIS FORSEH BUNGAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11519 FEBRUARY CIR APT 103
SILVER SPRING MD
20904-6984
US

IV. Provider business mailing address

11519 FEBRUARY CIR APT 103
SILVER SPRING MD
20904-6984
US

V. Phone/Fax

Practice location:
  • Phone: 240-676-9297
  • Fax:
Mailing address:
  • Phone: 240-676-9297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: