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General NPI Number Information
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NPI Number | 1225151640
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Entity Type | Individual
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Provider Name | MARCUS REGINALD CARSON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 631 CHERRY HILL RD
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City | BALTIMORE
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State | MD
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Zip | 21225-1228
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Country | US
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Telephone | 410-355-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 3954 BALLET WAY
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1399
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Country | US
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Telephone | 301-476-9527
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 16386
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License Number State | MD
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