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General NPI Number Information
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NPI Number | 1972883007
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Entity Type | Individual
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Provider Name | TEWODROS E WOLDEMARIAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2011
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Last Update Date | 08/21/2011
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Provider Practice Location Address
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Address Line | 12222 VEIRS MILL RD
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City | SILVER SPRING
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State | MD
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Zip | 20906-4505
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Country | US
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Telephone | 301-949-6212
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Fax |
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Provider Business Mailing Address
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Address Line | 7019 GEORGIA AVE. NW APT 312
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City | WASHINGTON
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State | DC
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Zip | 20012
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Country | US
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Telephone | 202-243-8418
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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 | 20347
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License Number State | MD
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