Healthcare Provider Details

I. General information

NPI: 1629984471
Provider Name (Legal Business Name): EMMANUEL SARPONG SARPONG PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 OLD GEORGETOWN RD
BETHESDA MD
20814-1497
US

IV. Provider business mailing address

9218 BURLEY LN
LAUREL MD
20723-5819
US

V. Phone/Fax

Practice location:
  • Phone: 301-896-3100
  • Fax:
Mailing address:
  • Phone: 301-896-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number23171
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: