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NPI 1083139703

NPI 1083139703 : DEVIN RASHAD PAULK PHARMD : HILLCREST HEIGHTS, MD

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General NPI Number Information
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    NPI Number           |    1083139703
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    Entity Type          |    Individual 
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    Provider Name        |    DEVIN RASHAD PAULK PHARMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/03/2017
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    Last Update Date     |    08/03/2017
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Provider Practice Location Address
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    Address Line         |    3714 BRANCH AVE 
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    City                 |    HILLCREST HEIGHTS
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    State                |    MD
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    Zip                  |    20748-1402
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    Country              |    US
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    Telephone            |    904-248-2738
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 7065 
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    City                 |    UPPER MARLBORO
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    State                |    MD
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    Zip                  |    20792-7065
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    Country              |    US
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    Telephone            |    
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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       |    25129
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    License Number State |    MD
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