Healthcare Provider Details

I. General information

NPI: 1124743414
Provider Name (Legal Business Name): DOMINIC TWUMASI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 07/01/2023
Certification Date: 07/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14939 SHADY GROVE RD
ROCKVILLE MD
20850-7719
US

IV. Provider business mailing address

7523 AUGUSTINE WAY
GAITHERSBURG MD
20879-4585
US

V. Phone/Fax

Practice location:
  • Phone: 301-944-1585
  • Fax:
Mailing address:
  • Phone: 240-586-2908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28864
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: