Healthcare Provider Details

I. General information

NPI: 1912213059
Provider Name (Legal Business Name): RONALD NICHOLAS DIPAOLO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22411 JEFFERSON BLVD
SMITHSBURG MD
21783-2063
US

IV. Provider business mailing address

8001 DUSTIN DR
FREDERICK MD
21701-3303
US

V. Phone/Fax

Practice location:
  • Phone: 301-824-2211
  • Fax:
Mailing address:
  • Phone: 301-898-7561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number07922
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: