Provider Demographics
NPI:1174806491
Name:PATEL, MASUM V (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MASUM
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11160 VEIRS MILL RD
Mailing Address - Street 2:T1415
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2538
Mailing Address - Country:US
Mailing Address - Phone:301-946-8168
Mailing Address - Fax:301-946-8168
Practice Address - Street 1:11160 VEIRS MILL RD
Practice Address - Street 2:T1415
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2538
Practice Address - Country:US
Practice Address - Phone:301-946-8168
Practice Address - Fax:301-946-8168
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist