Provider Demographics
NPI:1134406051
Name:DUTHIERS, LILI OLGA (PHARMD)
Entity type:Individual
Prefix:
First Name:LILI
Middle Name:OLGA
Last Name:DUTHIERS
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 1:511 OAK RUN DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1274
Mailing Address - Country:US
Mailing Address - Phone:352-284-2259
Mailing Address - Fax:
Practice Address - Street 1:511 OAK RUN DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1274
Practice Address - Country:US
Practice Address - Phone:352-284-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist