Provider Demographics
NPI:1780291112
Name:MURAGURI, SIMON K (PHARMD)
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:K
Last Name:MURAGURI
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 1:4609 RIDDLE DR
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5702
Mailing Address - Country:US
Mailing Address - Phone:410-274-4720
Mailing Address - Fax:
Practice Address - Street 1:1403 E COLD SPRING LN STE B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3913
Practice Address - Country:US
Practice Address - Phone:410-800-4886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist