Healthcare Provider Details

I. General information

NPI: 1982802187
Provider Name (Legal Business Name): BRIAN E GROVER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S GREENE ST SUITE 400
BALTIMORE MD
21201-1504
US

IV. Provider business mailing address

29 S GREENE ST SUITE 400
BALTIMORE MD
21201-1504
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-3442
  • Fax: 410-328-6781
Mailing address:
  • Phone: 410-328-3442
  • Fax: 410-328-6781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number16521
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: