MEDICARE: DORIAN ROMAN KUROPAS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	23146	NC

General Provider Information

NPI Number	:	1629493739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIAN ROMAN KUROPAS PHARMD

Provider Business Mailing Address
First Line	:	7008 E WT HARRIS BLVD STE 4
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-4298
Country	:	US
Telephone Number	:	704-885-5669
Fax Number	:	704-536-2420

Provider Business Practice Location Address
First Line	:	7008 E WT HARRIS BLVD STE 4
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-4298
Country	:	US
Telephone Number	:	704-885-5669
Fax Number	:	704-536-2420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	03/31/2022

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