Provider Demographics
NPI:1225344336
Name:KESSE, ATTA PANYIN (PHARMD,MBA)
Entity Type:Individual
Prefix:
First Name:ATTA
Middle Name:PANYIN
Last Name:KESSE
Suffix:
Gender:M
Credentials:PHARMD,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SOUDER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MD
Mailing Address - Zip Code:21716-1245
Mailing Address - Country:US
Mailing Address - Phone:301-834-8100
Mailing Address - Fax:301-834-4481
Practice Address - Street 1:92 SOUDER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MD
Practice Address - Zip Code:21716-1245
Practice Address - Country:US
Practice Address - Phone:301-834-8100
Practice Address - Fax:301-834-4481
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD177341835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy