Provider Demographics
NPI:1376540997
Name:ENG, MARTY L (PHARMD, CGP, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARTY
Middle Name:L
Last Name:ENG
Suffix:
Gender:M
Credentials:PHARMD, CGP, RPH
Other - Prefix:
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Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:KUMC, DEPT. PHARM PRAC, MS 4047, RM B440
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-5372
Mailing Address - Fax:913-588-2355
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:KUMC, DEPT. PHARM PRAC, MS 4047, RM B440
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-5372
Practice Address - Fax:913-588-2355
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-133501835P1200X
TX395131835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy