Provider Demographics
NPI:1053834291
Name:HINDMAN, FREDERICK MARK JR
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:MARK
Last Name:HINDMAN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9106 PHILADELPHIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4331
Mailing Address - Country:US
Mailing Address - Phone:410-687-8113
Mailing Address - Fax:410-391-3922
Practice Address - Street 1:9106 PHILADELPHIA RD STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4331
Practice Address - Country:US
Practice Address - Phone:410-687-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD25000OtherMARYLAND BOARD OF PHARMACY