Individual provider Active NPI

Adam Foune Diallo

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Pasadena, MD
National Provider Identifier
1174259279
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
28652 Issued in MD
Practice address
28 Magothy Beach Rd
Pasadena, MD 21122-4428
Phone
(410) 437-6450
NPI assigned
Jul 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 28652 MD Primary

Addresses

Primary practice location

28 Magothy Beach Rd
Pasadena, MD 21122-4428

Mailing address

15828 Deer Creek CT
Laurel, MD 20707-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28652MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1174259279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15828 DEER CREEK CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MAGOTHY BEACH RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224428",
            "telephone_number": "410-437-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIALLO",
        "first_name": "ADAM",
        "middle_name": "FOUNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MD",
            "license": "28652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.