Provider Demographics
NPI:1841505112
Name:ISENBERG, CARL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:ISENBERG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 SOUTHERLY RD
Mailing Address - Street 2:APT 117
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2756
Mailing Address - Country:US
Mailing Address - Phone:724-541-2358
Mailing Address - Fax:
Practice Address - Street 1:2801 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3816
Practice Address - Country:US
Practice Address - Phone:410-732-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist