Provider Demographics
NPI:1053510875
Name:HAILU, SELAMAWIT (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:SELAMAWIT
Middle Name:
Last Name:HAILU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 COLESVILLE RD
Mailing Address - Street 2:APT 602
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4343
Mailing Address - Country:US
Mailing Address - Phone:443-570-7371
Mailing Address - Fax:
Practice Address - Street 1:8811 COLESVILLE RD
Practice Address - Street 2:APT 602
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4343
Practice Address - Country:US
Practice Address - Phone:443-570-7371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18106183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist