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General NPI Number Information
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NPI Number | 1972743755
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Entity Type | Individual
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Provider Name | MARTIN BRUCE BAXTER RPH
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Gender | Male
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 316 TALBOTT AVE SUITE A
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City | LAUREL
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State | MD
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Zip | 20707-4334
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Country | US
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Telephone | 301-617-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 316 TALBOTT AVE SUITE A
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City | LAUREL
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State | MD
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Zip | 20707-4334
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Country | US
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Telephone | 301-617-0555
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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 | PH100000411
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14610
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202007452
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18090
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License Number State | MD
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