Provider Demographics
NPI:1083068654
Name:SAAVEDRA, KEENE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEENE
Middle Name:
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 WASHINGTONIAN BLVD APT 807
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5332
Mailing Address - Country:US
Mailing Address - Phone:843-793-7483
Mailing Address - Fax:
Practice Address - Street 1:9890 WASHINGTONIAN BLVD APT 807
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5332
Practice Address - Country:US
Practice Address - Phone:843-793-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062444183500000X
AZS023876183500000X
TX65479183500000X
SC36579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist