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General NPI Number Information
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NPI Number | 1780626473
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Entity Type | Individual
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Provider Name | ULGEN SEMAYE FIDELI PHD, MSPH, PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 4494 N PALMER RD
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-4771
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Fax |
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Provider Business Mailing Address
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Address Line | 13417 WILD BIRD TER
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City | DARNESTOWN
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State | MD
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Zip | 20878-3973
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Country | US
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Telephone | 301-873-4717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110002050
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License Number State | VA
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