Provider Demographics
NPI:1316652530
Name:TAUB, MICHAEL BENJAMIN (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BENJAMIN
Last Name:TAUB
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 1:1510 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3814
Mailing Address - Country:US
Mailing Address - Phone:410-484-0196
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL RD STE 405
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1839
Practice Address - Country:US
Practice Address - Phone:410-323-1144
Practice Address - Fax:410-323-6161
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist