Provider Demographics
NPI:1558112003
Name:ASANO, IZUMI (PHARMD)
Entity Type:Individual
Prefix:
First Name:IZUMI
Middle Name:
Last Name:ASANO
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 1:3905 BANK ST APT 506
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2566
Mailing Address - Country:US
Mailing Address - Phone:785-341-8324
Mailing Address - Fax:
Practice Address - Street 1:5901 HOLABIRD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6015
Practice Address - Country:US
Practice Address - Phone:410-288-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist