Provider Demographics
NPI:1366247470
Name:NAM, EUNICE (PHARMD)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:NAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:YE JIN
Other - Middle Name:
Other - Last Name:NAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5223 FONT AVE
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7003
Mailing Address - Country:US
Mailing Address - Phone:410-530-0522
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:410-530-0522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH200004726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist