Provider Demographics
NPI:1912528191
Name:EDUSEI, COLLINS BROBBEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:COLLINS
Middle Name:BROBBEY
Last Name:EDUSEI
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 1:7706 MILESTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1754
Mailing Address - Country:US
Mailing Address - Phone:410-799-2020
Mailing Address - Fax:
Practice Address - Street 1:7706 MILESTONE PKWY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1754
Practice Address - Country:US
Practice Address - Phone:410-799-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist