Healthcare Provider Details

I. General information

NPI: 1285573253
Provider Name (Legal Business Name): MIR SHARIAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 UNIVERSITY BLVD W
KENSINGTON MD
20895-2123
US

IV. Provider business mailing address

924 HIGHLAND RIDGE AVE
GAITHERSBURG MD
20878-5837
US

V. Phone/Fax

Practice location:
  • Phone: 301-933-6165
  • Fax: 301-933-6185
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20693
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: