Provider Demographics
NPI:1114368222
Name:DOOLEY, GEORGE T (R PH)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:T
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RUSSET CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3210
Mailing Address - Country:US
Mailing Address - Phone:410-574-6470
Mailing Address - Fax:410-574-0712
Practice Address - Street 1:4 RUSSET CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-3210
Practice Address - Country:US
Practice Address - Phone:410-574-6470
Practice Address - Fax:410-574-0712
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7293183500000X
VA0202211118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist