Provider Demographics
NPI:1063576635
Name:FINK, JOHN PHILIP (PD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PHILIP
Last Name:FINK
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-3416
Mailing Address - Country:US
Mailing Address - Phone:410-686-5500
Mailing Address - Fax:410-687-1070
Practice Address - Street 1:901 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-3416
Practice Address - Country:US
Practice Address - Phone:410-686-5500
Practice Address - Fax:410-687-1070
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist