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General NPI Number Information
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NPI Number | 1073897856
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Entity Type | Individual
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Provider Name | MICHAEL DAVID MARTIN JR. PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 10175 LITTLE PATUXENT PKWY STE 800
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City | COLUMBIA
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State | MD
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Zip | 21044-2655
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Country | US
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Telephone | 380-222-2140
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Fax |
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Provider Business Mailing Address
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Address Line | 2966 ALUM TRAIL PL
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City | LEWIS CENTER
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State | OH
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Zip | 43035-8353
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Country | US
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Telephone | 380-222-2140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03325719
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License Number State | OH
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