Provider Demographics
NPI:1376093195
Name:CONTEH, ISHMEAL MOHAMED
Entity Type:Individual
Prefix:DR
First Name:ISHMEAL
Middle Name:MOHAMED
Last Name:CONTEH
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 1:8500 16TH ST APT T4
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2928
Mailing Address - Country:US
Mailing Address - Phone:202-768-2327
Mailing Address - Fax:
Practice Address - Street 1:22411 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-2063
Practice Address - Country:US
Practice Address - Phone:301-824-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist