Healthcare Provider Details

I. General information

NPI: 1225018161
Provider Name (Legal Business Name): MAGED S HANNA RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WICONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

7159 PEACE CHIMES CT
COLUMBIA MD
21045-5222
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-2113
  • Fax:
Mailing address:
  • Phone: 301-295-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1555
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: