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General NPI Number Information
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NPI Number | 1386469831
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Entity Type | Individual
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Provider Name | DISHA PATEL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 6480 OLD WATERLOO RD
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City | ELKRIDGE
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State | MD
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Zip | 21075-6508
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Country | US
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Telephone | 410-799-0291
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 OLD WATERLOO RD
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City | ELKRIDGE
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State | MD
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Zip | 21075-6508
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Country | US
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Telephone | 410-660-1324
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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 | 0202222425
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30138
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License Number State | MD
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