Provider Demographics
NPI:1083996524
Name:PFAFF, KEITH THOMAS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:THOMAS
Last Name:PFAFF
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 1:216 MOUNT CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9725
Mailing Address - Country:US
Mailing Address - Phone:410-329-6209
Mailing Address - Fax:410-357-8002
Practice Address - Street 1:216 MOUNT CARMEL RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9725
Practice Address - Country:US
Practice Address - Phone:410-329-6209
Practice Address - Fax:410-357-8002
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17405183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist