Healthcare Provider Details

I. General information

NPI: 1073838272
Provider Name (Legal Business Name): GEOFFREY ALLEN TWIGG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404A N FRUITLAND BLVD
SALISBURY MD
21801-7261
US

IV. Provider business mailing address

404A N FRUITLAND BLVD
SALISBURY MD
21801-7261
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-8401
  • Fax: 410-749-4870
Mailing address:
  • Phone: 410-749-8401
  • Fax: 410-749-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17989
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: