Provider Demographics
NPI:1932573607
Name:TAMFU, EMMANUELLA
Entity Type:Individual
Prefix:DR
First Name:EMMANUELLA
Middle Name:
Last Name:TAMFU
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 1:11729 BELTSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3147
Mailing Address - Country:US
Mailing Address - Phone:443-293-6428
Mailing Address - Fax:
Practice Address - Street 1:9519 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4105
Practice Address - Country:US
Practice Address - Phone:410-764-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist