Provider Demographics
NPI:1275924268
Name:WEANT, MALLIKA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MALLIKA
Middle Name:
Last Name:WEANT
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:BOX 3089 DUMC
Mailing Address - Street 2:DEPARTMENT OF PHARMACY
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-613-0857
Mailing Address - Fax:
Practice Address - Street 1:20 DUKE MEDICINE CIRCLE
Practice Address - Street 2:DUKE CANCER CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18375183500000X
KY014249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist