Provider Demographics
NPI:1871815936
Name:HANSON, KWAME (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KWAME
Middle Name:
Last Name:HANSON
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 1:9004 MANCHESTER RD APT 21
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4128
Mailing Address - Country:US
Mailing Address - Phone:240-765-4436
Mailing Address - Fax:
Practice Address - Street 1:8829 GREENBELT RD
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2451
Practice Address - Country:US
Practice Address - Phone:301-552-4753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist