Individual
JEAN P NOUBISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
546 N FREDERICK AVE, GAITHERSBURG, MD 20877-2504
(301) 948-3250
(301) 519-9424
Mailing address
546 N FREDERICK AVE, GAITHERSBURG, MD 20877-2504
(301) 948-3250
(301) 519-9424
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18484
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0652244
CVS/CAREMARK
MD
Enumeration date
06/15/2014
Last updated
08/20/2014
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