Provider Demographics
NPI:1760606404
Name:BASHAW, EDWARD DENNIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DENNIS
Last Name:BASHAW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19216 TILFORD WAY
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1458
Mailing Address - Country:US
Mailing Address - Phone:301-648-2759
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVE
Practice Address - Street 2:WO21 RM4628
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993-0002
Practice Address - Country:US
Practice Address - Phone:301-648-2759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist