Provider Demographics
NPI:1609209816
Name:TEFERA, BINYAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BINYAM
Middle Name:
Last Name:TEFERA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 METZEROTT RD
Mailing Address - Street 2:UNIT 306
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-5115
Mailing Address - Country:US
Mailing Address - Phone:404-354-8084
Mailing Address - Fax:
Practice Address - Street 1:3101 DONNELL DR
Practice Address - Street 2:TARGET PHARMACY
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-3204
Practice Address - Country:US
Practice Address - Phone:301-778-1652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist