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General NPI Number Information
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NPI Number | 1386837011
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Entity Type | Organization
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Legal Business Name | TELAHUN, SHRADER & RIVERA, MD
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 9131 PISCATAWAY RD STE 450
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City | CLINTON
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State | MD
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Zip | 20735-2543
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Country | US
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Telephone | 301-868-6700
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Fax | 301-868-3017
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Provider Business Mailing Address
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Address Line | 9131 PISCATAWAY RD STE 450
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City | CLINTON
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State | MD
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Zip | 20735-2543
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Country | US
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Telephone | 301-868-6700
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Fax | 301-868-3017
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AZEB TELAHUN
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Credential | MD
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Telephone | 301-868-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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