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General NPI Number Information
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NPI Number | 1053586024
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Entity Type | Individual
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Provider Name | JEFFERY A SHICK R.PH.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 08/03/2019
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Provider Practice Location Address
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Address Line | 4500 E WEST HWY STE 900
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City | BETHESDA
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State | MD
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Zip | 20814-3417
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Country | US
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Telephone | 301-657-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1351 MARYLAND AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20002-4407
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Country | US
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Telephone | 202-396-1458
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Fax | 301-634-5917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-22336
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License Number State | OH
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