Provider Demographics
NPI:1992146310
Name:ASHKEZARY, MEISAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MEISAM
Middle Name:
Last Name:ASHKEZARY
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 1:10301 PROCERA DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5476
Mailing Address - Country:US
Mailing Address - Phone:301-300-8544
Mailing Address - Fax:240-668-3221
Practice Address - Street 1:10301 PROCERA DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5476
Practice Address - Country:US
Practice Address - Phone:301-300-8544
Practice Address - Fax:240-668-3221
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-14
Last Update Date:2013-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist