Provider Demographics
NPI:1417739970
Name:O'BRIEN, MARY E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 CROSSROADS CIR UNIT 187
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2997
Mailing Address - Country:US
Mailing Address - Phone:443-528-2020
Mailing Address - Fax:
Practice Address - Street 1:5230 CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4983
Practice Address - Country:US
Practice Address - Phone:410-933-9680
Practice Address - Fax:443-425-3296
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist