MEDICARE: MR. SEYDI DIOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R224614	MD

General Provider Information

NPI Number	:	1164972683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEYDI DIOP

Provider Business Mailing Address
First Line	:	1232 DAMSEL RD
Second Line	:
City	:	ESSEX
State	:	MD
Zip	:	21221-5902
Country	:	US
Telephone Number	:	240-643-2738
Fax Number	:

Provider Business Practice Location Address
First Line	:	5425 W NORTH AVE
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-5938
Country	:	US
Telephone Number	:	240-643-2738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2016
Last Update Date	:	10/07/2016

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Directions to “ MR. SEYDI DIOP ” Practice Location

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