Provider Demographics
NPI:1033232194
Name:STODART, BRENDA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:L
Last Name:STODART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9426 HORIZON RUN RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0492
Mailing Address - Country:US
Mailing Address - Phone:301-827-3465
Mailing Address - Fax:301-827-4570
Practice Address - Street 1:9639 LOST KNIFE RD
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2618
Practice Address - Country:US
Practice Address - Phone:301-417-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist