Provider Demographics
NPI:1013510163
Name:PAUP, JEFFREY EUGENE
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:EUGENE
Last Name:PAUP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2472
Mailing Address - Country:US
Mailing Address - Phone:410-256-9870
Mailing Address - Fax:410-256-9869
Practice Address - Street 1:8905 BELAIR RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2472
Practice Address - Country:US
Practice Address - Phone:410-256-9870
Practice Address - Fax:410-256-9869
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist