Healthcare Provider Details

I. General information

NPI: 1174936157
Provider Name (Legal Business Name): ABDUSELAM SULEYMAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36729 OLD MILL RD
MILLVILLE DE
19967-6952
US

IV. Provider business mailing address

36729 OLD MILL RD
MILLVILLE DE
19967-6952
US

V. Phone/Fax

Practice location:
  • Phone: 302-539-3334
  • Fax:
Mailing address:
  • Phone: 302-539-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA10004521
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21880
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: