Provider Demographics
NPI:1972108264
Name:LUTZ, TAMMY LOUISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:LOUISE
Last Name:LUTZ
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 1:20 TANGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3644
Mailing Address - Country:US
Mailing Address - Phone:443-939-0440
Mailing Address - Fax:
Practice Address - Street 1:3601 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ARBUTUS
Practice Address - State:MD
Practice Address - Zip Code:21227-1627
Practice Address - Country:US
Practice Address - Phone:410-737-7712
Practice Address - Fax:410-737-7715
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist