Provider Demographics
NPI:1699119453
Name:AFANA, FORSI
Entity type:Individual
Prefix:MR
First Name:FORSI
Middle Name:
Last Name:AFANA
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 1:11612 STEWART LN APT 102
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2456
Mailing Address - Country:US
Mailing Address - Phone:240-640-4774
Mailing Address - Fax:
Practice Address - Street 1:11612 STEWART LN APT 102
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2456
Practice Address - Country:US
Practice Address - Phone:240-640-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC22818498172036172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker