Individual
MIRA AZIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6260 CRAIN HWY, LA PLATA, MD 20646-4258
(301) 934-9564
Mailing address
260 S REYNOLDS ST APT 809, ALEXANDRIA, VA 22304-4433
(571) 290-8572
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24645
MD
Other
Enumeration date
12/15/2017
Last updated
03/17/2018
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