Provider Demographics
NPI:1275133845
Name:SHETH, VAISHALI (PHARMD)
Entity Type:Individual
Prefix:
First Name:VAISHALI
Middle Name:
Last Name:SHETH
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 1:4764 DE INVIERNO PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5028
Mailing Address - Country:US
Mailing Address - Phone:443-929-5564
Mailing Address - Fax:
Practice Address - Street 1:6400A RIDGE RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-6271
Practice Address - Country:US
Practice Address - Phone:410-549-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist