Healthcare Provider Details

I. General information

NPI: 1730545088
Provider Name (Legal Business Name): STANLEY PYLES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 COLUMBIA GATEWAY DR SUITE 100 & 110
COLUMBIA MD
21046-2140
US

IV. Provider business mailing address

7100 COLUMBIA GATEWAY DR SUITE 100 & 110
COLUMBIA MD
21046-2140
US

V. Phone/Fax

Practice location:
  • Phone: 866-466-7779
  • Fax:
Mailing address:
  • Phone: 866-466-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number12285
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: