Provider Demographics
NPI:1922982784
Name:FORBANG, BOGHUMA
Entity type:Individual
Prefix:
First Name:BOGHUMA
Middle Name:
Last Name:FORBANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 SPOONBILL WAY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3507
Mailing Address - Country:US
Mailing Address - Phone:240-375-4500
Mailing Address - Fax:
Practice Address - Street 1:7304 LOANDA DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4273
Practice Address - Country:US
Practice Address - Phone:240-375-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator