Provider Demographics
NPI:1790557098
Name:SEYUM, HIWOT (RPH)
Entity Type:Individual
Prefix:
First Name:HIWOT
Middle Name:
Last Name:SEYUM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8714 BRADFORD RD APT 1
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-6092
Mailing Address - Country:US
Mailing Address - Phone:240-476-2248
Mailing Address - Fax:
Practice Address - Street 1:3715 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2123
Practice Address - Country:US
Practice Address - Phone:240-962-8092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist