Provider Demographics
NPI:1083174783
Name:MACKOWIAK, FRANK DONALD (RPH)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:DONALD
Last Name:MACKOWIAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 DOOLEY RD
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:MD
Mailing Address - Zip Code:21160
Mailing Address - Country:US
Mailing Address - Phone:410-452-9799
Mailing Address - Fax:410-452-9196
Practice Address - Street 1:1606 DOOLEY RD
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:MD
Practice Address - Zip Code:21160
Practice Address - Country:US
Practice Address - Phone:410-452-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD10548OtherMARYLAND BOARD OF PHARMACY