MEDICARE: DANIEL YOHANNES PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH100001854	DC

General Provider Information

NPI Number	:	1477168334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL YOHANNES PHARMD

Provider Business Mailing Address
First Line	:	4635 S CAPITOL ST SW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-2717
Country	:	US
Telephone Number	:	202-561-0939
Fax Number	:

Provider Business Practice Location Address
First Line	:	4635 S CAPITOL ST SW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-2717
Country	:	US
Telephone Number	:	202-561-0939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2020
Last Update Date	:	09/08/2020

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