Provider Demographics
NPI:1164972683
Name:DIOP, SEYDI
Entity Type:Individual
Prefix:MR
First Name:SEYDI
Middle Name:
Last Name:DIOP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 DAMSEL RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-5902
Mailing Address - Country:US
Mailing Address - Phone:240-643-2738
Mailing Address - Fax:
Practice Address - Street 1:5425 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-5938
Practice Address - Country:US
Practice Address - Phone:240-643-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224614163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse