Provider Demographics
NPI:1871888719
Name:XING, SHAN (PHARMD)
Entity type:Individual
Prefix:
First Name:SHAN
Middle Name:
Last Name:XING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10410 KENSINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10410 KENSINGTON PKWY
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2943
Practice Address - Country:US
Practice Address - Phone:301-929-3634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60000820183500000X
MD19175183500000X
VA0202208359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19175OtherMARYLAND PHARMACY LICENSE
VA0202208359OtherVA PHARMACY LICENSE
WAPH60000820OtherWA PHARMACY LICENSE