Provider Demographics
NPI:1427322817
Name:STILLER, KARL (RPH)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:STILLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10714 JOHN TURLEY PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3120
Mailing Address - Country:US
Mailing Address - Phone:703-278-1023
Mailing Address - Fax:
Practice Address - Street 1:5801 DEFENSE PENTAGON
Practice Address - Street 2:CORRIDOR 8, E-RING
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-5801
Practice Address - Country:US
Practice Address - Phone:703-692-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist