Individual
KELLY KOSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
711 W 40TH ST, BALTIMORE, MD 21211-2120
(410) 467-3343
Mailing address
711 W 40TH ST, BALTIMORE, MD 21211-2120
(410) 467-3343
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202214208
VA
183500000X
Pharmacist
Primary
23422
MD
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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