Wilbert W Ferguson III, PHARMD
Individual provider Active NPI Pharmacist · Brandywine, MD
NPI 1356628366 · NPPES record last updated Nov 4, 2011
Key facts
- NPI
- 1356628366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17220 (MD)
- Practice address
- 15922 Crain Hwy
T-2394
Brandywine, MD 20613-8047 - Phone
- (301) 720-9001
- Fax
- (301) 720-9011
- NPI assigned
- Nov 4, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17220 | MD | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17220 | MD | Yes |
Addresses
Primary practice location
15922 Crain Hwy
T-2394
Brandywine, MD 20613-8047
Mailing address
15922 Crain Hwy
T-2394
Brandywine, MD 20613-8047
Phone (301) 720-9001
Other providers in Brandywine, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.