Derek Etube, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

22934 Issued in MD

Practice address

1030 W 41St St Ste E
Baltimore, MD 21211-1662

Phone

(410) 235-0002

NPI assigned

Nov 13, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1194121566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 W 41ST ST STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111662",
            "telephone_number": "410-235-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W 41ST ST STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111662",
            "telephone_number": "410-235-0002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 W Northern Pkwy",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212153228",
            "country_code": "US",
            "telephone_number": "410-358-5777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETUBE",
        "first_name": "DEREK",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-13",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "22934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Ann Adiaha-Obong Etiebet, MD
• Etienne T. Ngoumgna
• Ashley Ettah
• Kelly Ettari
• Olanrewaju W Etti
• Noelle Dare Etube, PHARMD
• Ogechi W Etuh
• Uche Moses Etunnuh, PHARM.D
• Brian Euerle
• David M Euhus, MD

• Pharmacist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.