Individual
SAM KHOSRAVIANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6525 BELCREST RD, HYATTSVILLE, MD 20782-2003
(301) 209-6688
Mailing address
304 EDMONSTON DR, ROCKVILLE, MD 20851-1305
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27414
MD
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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