Healthcare Provider Details

I. General information

NPI: 1780153452
Provider Name (Legal Business Name): ANGELE PEDIE KAMDEM PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2018
Last Update Date: 11/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10276 S MD BLVD
DUNKIRK MD
20754-3028
US

IV. Provider business mailing address

5619 GOSHAWK CT
WALDORF MD
20601-4401
US

V. Phone/Fax

Practice location:
  • Phone: 410-257-0392
  • Fax: 410-257-0920
Mailing address:
  • Phone: 240-478-4168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25299
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: