Healthcare Provider Details

I. General information

NPI: 1487565164
Provider Name (Legal Business Name): MARIAM L DIABY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 COLUMBIA GATEWAY DR STE 100
COLUMBIA MD
21046-2955
US

IV. Provider business mailing address

11430 FALCON RIDGE CT
BELTSVILLE MD
20705-1446
US

V. Phone/Fax

Practice location:
  • Phone: 800-336-7874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberT27735
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: