Provider Demographics
NPI:1821670803
Name:GEORGE, SEPPO ELAME
Entity Type:Individual
Prefix:
First Name:SEPPO ELAME
Middle Name:
Last Name:GEORGE
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 1:11409 COLUMBIA PIKE APT 136
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2526
Mailing Address - Country:US
Mailing Address - Phone:301-768-1584
Mailing Address - Fax:
Practice Address - Street 1:11409 COLUMBIA PIKE APT 136
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2526
Practice Address - Country:US
Practice Address - Phone:301-768-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00193368376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide