Individual
SHAKIB POURIFARSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
662 QUINCE ORCHARD RD, GAITHERSBURG, MD 20878-1410
(301) 990-6993
Mailing address
11 CLEMSON CT, ROCKVILLE, MD 20850-1125
(301) 728-1919
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27564
MD
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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