Provider Demographics
NPI:1770685109
Name:SHUKLA, SHILPA K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:K
Last Name:SHUKLA
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 1:33 BELMORE RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6130
Mailing Address - Country:US
Mailing Address - Phone:443-768-1117
Mailing Address - Fax:410-605-7852
Practice Address - Street 1:33 BELMORE RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6130
Practice Address - Country:US
Practice Address - Phone:410-605-7541
Practice Address - Fax:410-605-7852
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1770681509Medicare NSC