Provider Demographics
NPI:1104177831
Name:MUNOZ, ANDREW (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MUNOZ
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 1:703 GIDDINGS AVE STE L1
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1471
Mailing Address - Country:US
Mailing Address - Phone:410-263-7440
Mailing Address - Fax:410-269-5947
Practice Address - Street 1:703 GIDDINGS AVE STE L1
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1471
Practice Address - Country:US
Practice Address - Phone:410-263-7440
Practice Address - Fax:410-269-5947
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20056183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist