Provider Demographics
NPI:1407205974
Name:SHIRODKAR-CHATIM, SANGEETA (RPH)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:SHIRODKAR-CHATIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 GUILFORD RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9140 GUILFORD RD
Practice Address - Street 2:SUITE K
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1811
Practice Address - Country:US
Practice Address - Phone:301-362-7823
Practice Address - Fax:301-362-7883
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist