Individual
CARLY ROSE PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4551 FORBES BLVD, LANHAM, MD 20706-4325
(301) 918-6500
Mailing address
4551 FORBES BLVD, LANHAM, MD 20706-4325
(301) 918-6500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28145
MD
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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