Provider Demographics
NPI:1053435982
Name:NORWOOD, SHONDALYN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SHONDALYN
Middle Name:
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 LONGRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-4185
Mailing Address - Country:US
Mailing Address - Phone:770-456-1984
Mailing Address - Fax:
Practice Address - Street 1:4925 LONGRIDGE DR
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-4185
Practice Address - Country:US
Practice Address - Phone:770-456-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA018616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist