Provider Demographics
NPI:1467995308
Name:BESHIR, TAWFIK
Entity Type:Individual
Prefix:
First Name:TAWFIK
Middle Name:
Last Name:BESHIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9378 PEP RALLY LN
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-3845
Mailing Address - Country:US
Mailing Address - Phone:301-789-2559
Mailing Address - Fax:
Practice Address - Street 1:9378 PEP RALLY LN
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-3845
Practice Address - Country:US
Practice Address - Phone:301-789-2559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-27
Last Update Date:2016-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist