Provider Demographics
NPI:1730495888
Name:TRAN, DUNG (RPH)
Entity Type:Individual
Prefix:
First Name:DUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-3614
Mailing Address - Country:US
Mailing Address - Phone:410-538-5124
Mailing Address - Fax:410-538-4990
Practice Address - Street 1:300 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3614
Practice Address - Country:US
Practice Address - Phone:410-538-5124
Practice Address - Fax:410-538-4990
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist