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Individual

DR. GRANT CALLOWAY PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
7845 WISE AVE, DUNDALK, MD 21222-3339
(410) 285-1401
Mailing address
904 LIGHT ST APT D, BALTIMORE, MD 21230-4063
(973) 271-9830

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21751
MD
183500000X
Pharmacist
RP448193
PA

Other

Enumeration date
08/15/2014
Last updated
08/15/2014
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