Provider Demographics
NPI:1235563362
Name:WIENCHEDJI, DOUGLAS THIERRY (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:THIERRY
Last Name:WIENCHEDJI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6802 WOODSTREAM CIR
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2134
Mailing Address - Country:US
Mailing Address - Phone:202-706-8281
Mailing Address - Fax:
Practice Address - Street 1:1420 K ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-2500
Practice Address - Country:US
Practice Address - Phone:202-293-2931
Practice Address - Fax:202-293-3480
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27492183500000X
374U00000X
PARP455185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No374U00000XNursing Service Related ProvidersHome Health Aide