Provider Demographics
NPI:1114950631
Name:ELSAMANOUDI, SALWA (MD)
Entity Type:Individual
Prefix:DR
First Name:SALWA
Middle Name:
Last Name:ELSAMANOUDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14701 HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5642
Mailing Address - Country:US
Mailing Address - Phone:301-384-9521
Mailing Address - Fax:
Practice Address - Street 1:2629 RIVA RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7428
Practice Address - Country:US
Practice Address - Phone:410-266-1000
Practice Address - Fax:410-573-4028
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0032499208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
700250OtherNCPPO
1201796OtherUNITED HEALTHCARE MCO
1981628OtherUNITED HEALTHCARE
9973OtherKAISER
281931OtherMAMSI
5808053OtherAETNA PPO
MD010266OtherJOHNS HOPKINS HEALTHCARE
3628495002OtherCIGNA
2328093OtherAETNA HMO
MD93126Medicaid
MD0024OtherCAREFIRST DC
113382OtherCOVENTRY
MD35168709OtherCAREFIRST MARYLAND
1201796OtherUNITED HEALTHCARE MCO
MD35168709OtherCAREFIRST MARYLAND