MEDICARE: DR. SYLVIE NANGUE TIADEM PHARM D

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	PH100001502	DC
2	183500000X	Pharmacist	21983	MD

General Provider Information

NPI Number	:	1386023836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIE NANGUE TIADEM PHARM D

Provider Business Mailing Address
First Line	:	6101 16TH ST NW APT 508
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-1761
Country	:	US
Telephone Number	:	202-494-4885
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 16TH ST NW APT 508
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-1761
Country	:	US
Telephone Number	:	202-494-4885
Fax Number	:

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

Provider Enumeration Date	:	05/28/2015
Last Update Date	:	05/28/2015

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