Provider Demographics
NPI:1588216105
Name:LEMMA, TIGEST T
Entity Type:Individual
Prefix:
First Name:TIGEST
Middle Name:T
Last Name:LEMMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 DOBBIN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2898
Mailing Address - Country:US
Mailing Address - Phone:410-290-1660
Mailing Address - Fax:443-741-3098
Practice Address - Street 1:6111 DOBBIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2898
Practice Address - Country:US
Practice Address - Phone:410-290-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-13
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist