Provider Demographics
NPI:1790200400
Name:DUGGARAJU, POOJA (PHARMD)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:DUGGARAJU
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 1:12736 WINDYEDGE RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2236
Mailing Address - Country:US
Mailing Address - Phone:704-947-9022
Mailing Address - Fax:
Practice Address - Street 1:3062 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2659
Practice Address - Country:US
Practice Address - Phone:828-728-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist