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Individual

SHAWN RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
510 UPPER CHESAPEAKE DR, SUITE 414, BEL AIR, MD 21014-4328
(443) 643-3190
(443) 643-3195
Mailing address
510 UPPER CHESAPEAKE DR, SUITE 414, BEL AIR, MD 21014-4328
(443) 643-3190
(443) 643-3195

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18348
MD

Other

Enumeration date
09/23/2009
Last updated
09/26/2009
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