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General NPI Number Information
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NPI Number | 1902456502
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Entity Type | Individual
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Provider Name | MR. FOUSSEYNI M DIAWARA
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Gender | Male
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 1680 E GUDE DR STE 302
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 301-605-5572
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Fax | 240-863-3007
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Provider Business Mailing Address
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Address Line | 1680 E GUDE DR STE 302
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City | ROCKVILLE
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State | MD
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Zip | 20850-1372
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Country | US
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Telephone | 301-339-4217
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Fax | 240-863-3007
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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 | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 101493
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License Number State | MD
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