Shilpi Gumubula
Individual provider Active NPI Pharmacist · Brambleton, VA
NPI 1306131941 · NPPES record last updated Jun 11, 2011
Key facts
- NPI
- 1306131941
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202206472 (VA)
- Practice address
- 42846 Conquest Cir
Brambleton, VA 20148-7221 - Phone
- (703) 880-8993
- NPI assigned
- Jun 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202206472 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202206472 | VA | Yes |
Addresses
Primary practice location
42846 Conquest Cir
Brambleton, VA 20148-7221
Mailing address
42846 Conquest Cir
Brambleton, VA 20148-7221
Phone (703) 880-8993
Other providers in Brambleton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.