Selamawitt Gedamu
Individual provider Active NPI Pharmacist · Glenarden, MD
NPI 1699015016 · NPPES record last updated Feb 21, 2013
Key facts
- NPI
- 1699015016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 16992 (MD)
- Practice address
- 2400 Five Lees LN
Glenarden, MD 20706-1617 - Phone
- (301) 341-6749
- Fax
- (301) 341-6746
- NPI assigned
- Feb 21, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16992 | MD | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16992 | MD | Yes |
Addresses
Primary practice location
2400 Five Lees LN
Glenarden, MD 20706-1617
Mailing address
2400 Five Lees LN
Glenarden, MD 20706-1617
Phone (301) 341-6749
Other providers in Glenarden, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.