Provider Demographics
NPI:1023543147
Name:SCHNUPP, KEVIN ALBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALBERT
Last Name:SCHNUPP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:RIDERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21139-0242
Mailing Address - Country:US
Mailing Address - Phone:443-465-9173
Mailing Address - Fax:
Practice Address - Street 1:1025 WAGNER RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6821
Practice Address - Country:US
Practice Address - Phone:443-465-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD094641835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy