Provider Demographics
NPI:1437821592
Name:BOLAND, SHAWN MARIE (PHARMD, MS, CPPS)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MARIE
Last Name:BOLAND
Suffix:
Gender:F
Credentials:PHARMD, MS, CPPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16231 SHAFFER RD
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21782-1036
Mailing Address - Country:US
Mailing Address - Phone:240-626-3873
Mailing Address - Fax:
Practice Address - Street 1:11116 MEDICAL CAMPUS RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6710
Practice Address - Country:US
Practice Address - Phone:301-790-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist