Provider Demographics
NPI:1063811313
Name:OPEL, SHAWN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:OPEL
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 1:12500 COUNTRY CLUB MALL RD
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7553
Mailing Address - Country:US
Mailing Address - Phone:301-729-5088
Mailing Address - Fax:301-729-5256
Practice Address - Street 1:12500 COUNTRY CLUB MALL RD
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7553
Practice Address - Country:US
Practice Address - Phone:301-729-5088
Practice Address - Fax:301-729-5256
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist