Provider Demographics
NPI:1255311080
Name:PRATT, ROBERT G (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:PRATT
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 1:11630 SCARLET LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6048
Mailing Address - Country:US
Mailing Address - Phone:301-528-5869
Mailing Address - Fax:
Practice Address - Street 1:11630 SCARLET LEAF CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6048
Practice Address - Country:US
Practice Address - Phone:301-528-5869
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist