Provider Demographics
NPI:1306128954
Name:TAYLOR-ANTHONY, TAKIA SHANEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAKIA
Middle Name:SHANEL
Last Name:TAYLOR-ANTHONY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TAKIA
Other - Middle Name:
Other - Last Name:TAYLOR-ANTHONY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7318 ARCHSINE LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6929
Mailing Address - Country:US
Mailing Address - Phone:443-810-6466
Mailing Address - Fax:410-265-8735
Practice Address - Street 1:2204 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-1825
Practice Address - Country:US
Practice Address - Phone:410-265-8593
Practice Address - Fax:410-265-8735
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist