Provider Demographics
NPI:1689961583
Name:SHERRILL, MARISSA DEV DICOLA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:DEV DICOLA
Last Name:SHERRILL
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 1:167 STONEWALL JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-1720
Mailing Address - Country:US
Mailing Address - Phone:910-431-0049
Mailing Address - Fax:
Practice Address - Street 1:6901 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-9727
Practice Address - Country:US
Practice Address - Phone:910-395-5373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17778183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist