Fabrice Djoukam, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

25401 Issued in MD

Practice address

6480 Old Waterloo Rd
Elkridge, MD 21075-6508

Phone

(410) 799-0291

NPI assigned

Sep 5, 2020

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1164036216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3574 POWDER MILL RD APT 203",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053525",
            "telephone_number": "240-381-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 OLD WATERLOO RD",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756508",
            "telephone_number": "410-799-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOUKAM",
        "first_name": "FABRICE",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-05",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "25401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "address_1": "6480 Old Waterloo Rd",
            "city": "Elkridge",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210756508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6480 Old Waterloo Rd",
            "city": "Elkridge",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210756508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2020; 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.