Provider Demographics
NPI:1518625748
Name:ALSAMMAN, MOHAMMAD LOUAI (RPH)
Entity type:Individual
Prefix:
First Name:MOHAMMAD LOUAI
Middle Name:
Last Name:ALSAMMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42757 LOCKLEAR TER
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6634
Mailing Address - Country:US
Mailing Address - Phone:612-806-5414
Mailing Address - Fax:571-454-7001
Practice Address - Street 1:12890 TOUCHSTONE CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7648
Practice Address - Country:US
Practice Address - Phone:612-806-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29701183500000X
DCPH200004908183500000X
MN125459183500000X
VA0202221676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist