Healthcare Provider Details

I. General information

NPI: 1871733485
Provider Name (Legal Business Name): MISGANAW ASMARE ALEMU PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 COLUMBIA RD NW APT 27
WASHINGTON DC
20009-4718
US

IV. Provider business mailing address

1429 COLUMBIA RD NW APT 27
WASHINGTON DC
20009-4718
US

V. Phone/Fax

Practice location:
  • Phone: 202-518-0809
  • Fax:
Mailing address:
  • Phone: 202-518-0809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberA1-0003675
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: