Provider Demographics
NPI:1346948817
Name:PRADHAN, ASHWINI
Entity Type:Individual
Prefix:
First Name:ASHWINI
Middle Name:
Last Name:PRADHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SULPHUR SPRING RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2701
Mailing Address - Country:US
Mailing Address - Phone:410-737-9221
Mailing Address - Fax:
Practice Address - Street 1:1400 SULPHUR SPRING RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-2701
Practice Address - Country:US
Practice Address - Phone:410-737-9221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD28998OtherMARYLAND BOARD OF PHARMACY