Provider Demographics
NPI:1952513970
Name:BRESETTE, JAMES L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:BRESETTE
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 1:9512 WINDBEAT WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2056
Mailing Address - Country:US
Mailing Address - Phone:301-617-8578
Mailing Address - Fax:
Practice Address - Street 1:7500 SECURITY BLVD
Practice Address - Street 2:MAIL STOP WB 06-05
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-1849
Practice Address - Country:US
Practice Address - Phone:410-786-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14679183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist