MEDICARE: EMILY THI PHUONG DANG PHARMD

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	183500000X	Pharmacist	25283	MD

General Provider Information

NPI Number	:	1184139925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY THI PHUONG DANG PHARMD

Provider Business Mailing Address
First Line	:	100 WALDON RD APT B
Second Line	:
City	:	ABINGDON
State	:	MD
Zip	:	21009-2110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 CARROLL ISLAND RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21220-2208
Country	:	US
Telephone Number	:	410-335-1135
Fax Number	:

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

Provider Enumeration Date	:	12/01/2017
Last Update Date	:	12/01/2017

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