Provider Demographics
NPI:1316234123
Name:GLEESPEN, PAUL M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:GLEESPEN
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 1:7005 SECURITY BLVD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2533
Mailing Address - Country:US
Mailing Address - Phone:410-298-4759
Mailing Address - Fax:410-298-4942
Practice Address - Street 1:7005 SECURITY BLVD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2533
Practice Address - Country:US
Practice Address - Phone:410-298-4759
Practice Address - Fax:410-298-4942
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist