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General NPI Number Information
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NPI Number | 1215058680
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Entity Type | Individual
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Provider Name | SHIRISH A PATIL R.PH
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22 S GREENE ST DEPT OF PHARMACY SERVICES, ROOM 400
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City | BALTIMORE
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State | MD
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Zip | 21201-1544
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Country | US
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Telephone | 410-328-3178
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 THOMAS RUN CIR
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City | BEL AIR
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State | MD
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Zip | 21015-1581
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Country | US
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Telephone | 410-420-1565
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Fax |
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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 | 14888
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License Number State | MD
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