Provider Demographics
NPI:1982141891
Name:KIRCHOFF, MATTHEW (PHARMD, MS, MBA)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:KIRCHOFF
Suffix:
Gender:M
Credentials:PHARMD, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 FISHERS LN
Mailing Address - Street 2:RM 4B15
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1792
Mailing Address - Country:US
Mailing Address - Phone:301-312-1697
Mailing Address - Fax:
Practice Address - Street 1:5601 FISHERS LN
Practice Address - Street 2:RM 4B15
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1792
Practice Address - Country:US
Practice Address - Phone:301-312-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 45008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist