Provider Demographics
NPI:1376942516
Name:SPOELHOF, KEITH JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:JAMES
Last Name:SPOELHOF
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 1:4931 POWDER MILL RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1939
Mailing Address - Country:US
Mailing Address - Phone:585-507-0761
Mailing Address - Fax:
Practice Address - Street 1:5200 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-4215
Practice Address - Country:US
Practice Address - Phone:410-433-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist