Healthcare Provider Details

I. General information

NPI: 1245561703
Provider Name (Legal Business Name): MARK SAMUEL EPSTEIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 M ST NW
WASHINGTON DC
20037-1427
US

IV. Provider business mailing address

2301 M ST NW
WASHINGTON DC
20037-1427
US

V. Phone/Fax

Practice location:
  • Phone: 202-419-6367
  • Fax:
Mailing address:
  • Phone: 202-419-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number62919
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number19222
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH100001973
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0202214060
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: