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General NPI Number Information
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NPI Number | 1316659816
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Entity Type | Individual
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Provider Name | CARRIE MARIE MATLICK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 251 N 4TH ST
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City | OAKLAND
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State | MD
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Zip | 21550-1375
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Country | US
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Telephone | 301-533-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 169 GOLDEN WOODS CT
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City | SWANTON
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State | MD
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Zip | 21561-1174
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Country | US
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Telephone | 301-501-2679
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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 | 17919
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License Number State | MD
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