Provider Demographics
NPI:1679174759
Name:GOLES, FELISA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FELISA
Middle Name:
Last Name:GOLES
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 1:3299 EMMORTON RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2013
Mailing Address - Country:US
Mailing Address - Phone:410-420-3162
Mailing Address - Fax:410-420-3190
Practice Address - Street 1:3299 EMMORTON RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-2013
Practice Address - Country:US
Practice Address - Phone:410-420-3162
Practice Address - Fax:410-420-3190
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist