Provider Demographics
NPI:1497031868
Name:WALTHER, ELISABETH (PHARMD, JD)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:WALTHER
Suffix:
Gender:F
Credentials:PHARMD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4904
Mailing Address - Country:US
Mailing Address - Phone:301-983-4890
Mailing Address - Fax:
Practice Address - Street 1:10101 RIVER RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4904
Practice Address - Country:US
Practice Address - Phone:301-983-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist