MEDICARE: DR. SYLVAIN VALERE SOB TANEMOSSU PHD, 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	374U00000X	Home Health Aide
2	183500000X	Pharmacist	26782	MD

General Provider Information

NPI Number	:	1184975195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVAIN VALERE SOB TANEMOSSU PHD, PHARMD

Provider Business Mailing Address
First Line	:	11548 FEBRUARY CIR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-6930
Country	:	US
Telephone Number	:	202-403-9356
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 OLD COLUMBIA PIKE APT 1812
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-2558
Country	:	US
Telephone Number	:	202-545-0935
Fax Number	:	202-545-0176

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

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	07/03/2020

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