Provider Demographics
NPI:1144244492
Name:NA, PAUL J (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:NA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10805 HICKORY RIDGE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3626
Mailing Address - Country:US
Mailing Address - Phone:410-964-6409
Mailing Address - Fax:410-964-6493
Practice Address - Street 1:10805 HICKORY RIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3626
Practice Address - Country:US
Practice Address - Phone:410-964-6409
Practice Address - Fax:410-964-6493
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist