Provider Demographics
NPI:1548863236
Name:SEGURA, DANIA (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIA
Middle Name:
Last Name:SEGURA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 LOVING FOREST CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3717
Mailing Address - Country:US
Mailing Address - Phone:703-455-2870
Mailing Address - Fax:
Practice Address - Street 1:13047 FAIR LAKES SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-5179
Practice Address - Country:US
Practice Address - Phone:703-449-8186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26077183500000X
DCPH100003049183500000X
VA0202216203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist