Healthcare Provider Details

I. General information

NPI: 1548123508
Provider Name (Legal Business Name): RAZAQ SALAU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5535 HARFORD RD
BALTIMORE MD
21214-2233
US

IV. Provider business mailing address

5411 MCGRATH BLVD APT 1518
ROCKVILLE MD
20852-8634
US

V. Phone/Fax

Practice location:
  • Phone: 410-800-4886
  • Fax: 410-864-8941
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30637
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: