Provider Demographics
NPI:1255749933
Name:DONIS, NICHOLAS (PHARMD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:DONIS
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 1:1519 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2833
Mailing Address - Country:US
Mailing Address - Phone:410-638-8757
Mailing Address - Fax:410-838-4683
Practice Address - Street 1:1519 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2833
Practice Address - Country:US
Practice Address - Phone:410-638-8757
Practice Address - Fax:410-838-4683
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20023183500000X
PARP444225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist