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General NPI Number Information
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NPI Number | 1659599041
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Entity Type | Individual
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Provider Name | SHIRLEY TABAH NZO-NGUTY
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19721 FREDERICK RD
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City | GERMANTOWN
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State | MD
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Zip | 20876-1337
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Country | US
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Telephone | 301-428-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 11205 ARROWLEAF CT
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City | GERMANTOWN
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State | MD
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Zip | 20876-6029
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Country | US
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Telephone | 301-938-6593
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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 | 14658
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License Number State | MD
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