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General NPI Number Information
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NPI Number | 1194948935
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Entity Type | Individual
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Provider Name | MARCUS THOMAS CARSON P.D
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7153 SECURITY BLVD
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City | BALTIMORE
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State | MD
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Zip | 21244-1811
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Country | US
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Telephone | 410-944-6400
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Fax | 410-944-2492
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Provider Business Mailing Address
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Address Line | 3827 JANBROOK RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2705
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Country | US
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Telephone | 443-904-3025
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Fax | 410-521-5875
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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 | 07758
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License Number State | MD
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