Healthcare Provider Details

I. General information

NPI: 1396146544
Provider Name (Legal Business Name): JAMES KUTTEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 N FREDERICK AVE
GAITHERSBURG MD
20877-2504
US

IV. Provider business mailing address

546 N FREDERICK AVE
GAITHERSBURG MD
20877-2504
US

V. Phone/Fax

Practice location:
  • Phone: 301-948-3250
  • Fax: 301-519-9242
Mailing address:
  • Phone: 301-948-3250
  • Fax: 301-519-9242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11931
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number11931
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: