Active NPI
Milen Tesfamariam
- Pharmacist
- La Plata, MD
National Provider Identifier
1255933396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 24839
- Practice address
- 200 Rosewick Rd
La Plata, MD 20646-4216 - Phone
- (301) 392-5485
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24839 | MD | Primary |
Addresses
Primary practice location
200 Rosewick Rd
La Plata, MD 20646-4216
Mailing address
200 Rosewick Rd
La Plata, MD 20646-4216
Phone (301) 392-5485
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24839 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giant of Maryland LLC | Past | Accepting new patients | |
| Giant of Maryland LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1255933396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 ROSEWICK RD",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206464216",
"telephone_number": "301-392-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 ROSEWICK RD",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206464216",
"telephone_number": "301-392-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESFAMARIAM",
"first_name": "MILEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "24839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Plata, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.