Provider Demographics
NPI:1528355351
Name:TSOUROUNIS, MARILYN MATTHEWS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:MATTHEWS
Last Name:TSOUROUNIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20908 FREDERICK RD
Mailing Address - Street 2:T-1046
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4134
Mailing Address - Country:US
Mailing Address - Phone:443-624-8923
Mailing Address - Fax:
Practice Address - Street 1:20908 FREDERICK RD
Practice Address - Street 2:T-1046
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4134
Practice Address - Country:US
Practice Address - Phone:443-624-8923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist