Healthcare Provider Details

I. General information

NPI: 1922716372
Provider Name (Legal Business Name): TAYLOR MARIE SOUTHERS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 TEAGUE RD STE 210
HANOVER MD
21076-1941
US

IV. Provider business mailing address

7580 BUCKINGHAM BLVD STE 220
HANOVER MD
21076-3210
US

V. Phone/Fax

Practice location:
  • Phone: 410-551-0499
  • Fax: 410-799-9070
Mailing address:
  • Phone: 410-729-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28896
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: