Provider Demographics
NPI:1689961781
Name:WILLIAMS, SHEENA RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:RENEE
Last Name:WILLIAMS
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 1:1330 MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-4104
Mailing Address - Country:US
Mailing Address - Phone:410-406-9082
Mailing Address - Fax:410-406-9082
Practice Address - Street 1:1330 MARTIN BLVD
Practice Address - Street 2:T-1970
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-4104
Practice Address - Country:US
Practice Address - Phone:410-406-9082
Practice Address - Fax:410-406-9082
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist