Healthcare Provider Details

I. General information

NPI: 1346244175
Provider Name (Legal Business Name): COLBY ALLYN MILLER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

390 MADISON DR
SHREWSBURY PA
17361-1628
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-8882
  • Fax:
Mailing address:
  • Phone: 717-235-8764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number15713
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: