Provider Demographics
NPI:1114145901
Name:WESTENDORF, HEATHER L (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:WESTENDORF
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2809 BOSTON ST
Mailing Address - Street 2:#212
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12300 KILN CT
Practice Address - Street 2:STE D
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1357
Practice Address - Country:US
Practice Address - Phone:301-210-4343
Practice Address - Fax:301-210-6996
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD180701835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear