Healthcare Provider Details

I. General information

NPI: 1114950631
Provider Name (Legal Business Name): SALWA ELSAMANOUDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 RIVA RD SUITE 112
ANNAPOLIS MD
21401-7428
US

IV. Provider business mailing address

14701 HARVEST LN
SILVER SPRING MD
20905-5642
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-1000
  • Fax: 410-573-4028
Mailing address:
  • Phone: 301-384-9521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0032499
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: