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General NPI Number Information
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NPI Number | 1437583861
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Entity Type | Individual
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Provider Name | SEVAG DISHAKJIAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 11109 US 15-501 UNIT 1804
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City | ABERDEEN
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State | NC
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Zip | 28315-2306
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Country | US
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Telephone | 910-692-3048
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Fax | 910-692-3321
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Provider Business Mailing Address
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Address Line | 11109 US 15-501 UNIT 1804
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City | ABERDEEN
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State | NC
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Zip | 28315-2306
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Country | US
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Telephone | 910-692-3048
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Fax | 910-692-3321
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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 | 16811
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License Number State | NC
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