Provider Demographics
NPI:1578995148
Name:MUNFORD, FREDERICK L SR (RPH, MS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:L
Last Name:MUNFORD
Suffix:SR
Gender:M
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 JUNALUSKA TER
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4312
Mailing Address - Country:US
Mailing Address - Phone:240-731-5182
Mailing Address - Fax:301-297-5096
Practice Address - Street 1:8805 JUNALUSKA TER
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4312
Practice Address - Country:US
Practice Address - Phone:240-731-5182
Practice Address - Fax:301-297-5096
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08236183500000X
DCPHA2074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist