Provider Demographics
NPI:1528353174
Name:BUSICK, MICHELLE J (RPH)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:BUSICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:J
Other - Last Name:WINKLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4940 EASTERN AVE RM 1-1343
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2735
Mailing Address - Country:US
Mailing Address - Phone:410-550-5180
Mailing Address - Fax:410-550-5181
Practice Address - Street 1:4940 EASTERN AVE RM 1-1343
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-5180
Practice Address - Fax:410-550-5181
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-12
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist