Marty L Eng, PHARMD, BCGP, RPH
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Wpafb, OH
NPI 1376540997 · NPPES record last updated Dec 12, 2024
Key facts
- NPI
- 1376540997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 03132438 (OH)
- Practice address
- 4881 Sugar Maple Dr
Wpafb, OH 45433-5529 - Phone
- (937) 257-8718
- NPI assigned
- Jun 29, 2005
- Sex
- Male
- Sole proprietor
- No
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, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03132438 | OH | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 1-13350 | KS | MD | Pharmacotherapy Pharmacist |
| 39513 | TX | MD | Pharmacotherapy Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 39513 | TX | |
| Pharmacotherapy Pharmacist | 1835P1200X | 1-13350 | KS | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 03132438 | OH | Yes |
Addresses
Primary practice location
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Mailing address
4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Other providers in Wpafb, OH
- Matthew Duenes
- Jennifer E Eby
- Alexander Edwards
- Ashley N Edwards
- George Stephen Edwardson Jr.
- Maggie Eviston
- Anastassia Fennel
- Douglas Scott Files
- Rosalinda Fitts
- Mary Jane Foos
All providers in Wpafb, OH · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2024. 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.