Provider Demographics
NPI:1437583861
Name:DISHAKJIAN, SEVAG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEVAG
Middle Name:
Last Name:DISHAKJIAN
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 1:11109 US 15-501
Mailing Address - Street 2:UNIT 1804
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2306
Mailing Address - Country:US
Mailing Address - Phone:910-692-3048
Mailing Address - Fax:910-692-3321
Practice Address - Street 1:11109 US 15-501
Practice Address - Street 2:UNIT 1804
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2306
Practice Address - Country:US
Practice Address - Phone:910-692-3048
Practice Address - Fax:910-692-3321
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist