Provider Demographics
NPI:1972377547
Name:COLSON, MARY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:COLSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4506
Mailing Address - Country:US
Mailing Address - Phone:240-439-6310
Mailing Address - Fax:
Practice Address - Street 1:1 FREDERICK HEALTH WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-9435
Practice Address - Country:US
Practice Address - Phone:240-566-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist