Healthcare Provider Details

I. General information

NPI: 1982988739
Provider Name (Legal Business Name): QUMERUNNISA SYED PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6498 LANDOVER RD
CHEVERLY MD
20785-1444
US

IV. Provider business mailing address

6498 LANDOVER RD
CHEVERLY MD
20785-1444
US

V. Phone/Fax

Practice location:
  • Phone: 301-773-1074
  • Fax:
Mailing address:
  • Phone: 301-773-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21508
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26023406A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: