Healthcare Provider Details

I. General information

NPI: 1346890019
Provider Name (Legal Business Name): SARA TADIOS MUNIE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR STE 300
GLEN BURNIE MD
21061-5884
US

IV. Provider business mailing address

1111 N CHARLES ST
BALTIMORE MD
21201-5505
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-7331
  • Fax:
Mailing address:
  • Phone: 410-837-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number2599
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: