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General NPI Number Information
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NPI Number | 1922319425
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Entity Type | Individual
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Provider Name | MADHURIMA AGUMAMIDI M.S
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Gender | Female
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 101 N EAST PLZ
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City | NORTH EAST
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State | MD
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Zip | 21901-3633
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Country | US
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Telephone | 410-287-5220
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Fax | 410-287-6560
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Provider Business Mailing Address
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Address Line | 18 LATOUR LN
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City | NEWARK
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State | DE
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Zip | 19702-4544
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Country | US
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Telephone | 302-365-5131
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17043
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | A1-0003693
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03342800
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License Number State | NJ
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