Provider Demographics
NPI:1366018996
Name:PILLSBURY, DEBORAH (PD)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:PILLSBURY
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2847
Mailing Address - Country:US
Mailing Address - Phone:410-310-7498
Mailing Address - Fax:
Practice Address - Street 1:204 S TALBOT STREET
Practice Address - Street 2:
Practice Address - City:SAINY MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663
Practice Address - Country:US
Practice Address - Phone:410-745-8382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist