Individual
DR. WANA MANITPISITKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4960 WALKING STICK RD, APT H, ELLICOTT CITY, MD 21043-8058
(410) 328-9701
Mailing address
4960 WALKING STICK RD, APT H, ELLICOTT CITY, MD 21043-8058
(410) 328-9701
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
17787
MD
Other
Enumeration date
04/11/2011
Last updated
04/11/2011
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