Provider Demographics
NPI:1467596908
Name:VOGEL, MARY B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:B
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 N TUCKAHOE ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1965
Mailing Address - Country:US
Mailing Address - Phone:703-532-0815
Mailing Address - Fax:
Practice Address - Street 1:101 W BROAD ST FL 3
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4229
Practice Address - Country:US
Practice Address - Phone:703-531-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist