Provider Demographics
NPI:1245665439
Name:COBB, JAMES M (RPHT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:M
Last Name:COBB
Suffix:
Gender:M
Credentials:RPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 DORSEY HALL DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-5975
Mailing Address - Country:US
Mailing Address - Phone:410-992-3797
Mailing Address - Fax:
Practice Address - Street 1:4715 DORSEY HALL DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-5975
Practice Address - Country:US
Practice Address - Phone:410-992-3797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT00233183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician