Provider Demographics
NPI:1972843191
Name:MINOT, MAUREEN CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CHRISTINE
Last Name:MINOT
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 1:1518 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4625
Mailing Address - Country:US
Mailing Address - Phone:267-800-4951
Mailing Address - Fax:
Practice Address - Street 1:221 W COLLEGE AVE FL 2
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5826
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-25
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25507183500000X
PARP447241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist