Provider Demographics
NPI:1477655587
Name:SHILLIDAY, MARY ELIZABETH BRYANT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY ELIZABETH
Middle Name:BRYANT
Last Name:SHILLIDAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12608 AMORETTO WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-6167
Mailing Address - Country:US
Mailing Address - Phone:919-843-0391
Mailing Address - Fax:919-966-4507
Practice Address - Street 1:5039 OLD CLINIC BLDG
Practice Address - Street 2:CB # 7110
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7110
Practice Address - Country:US
Practice Address - Phone:919-843-0391
Practice Address - Fax:919-966-4507
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC14444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC700010OtherCPP #