Provider Demographics
NPI:1538386834
Name:SHARE, ROBERT DAVID (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:SHARE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TELFORD LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3323
Mailing Address - Country:US
Mailing Address - Phone:856-235-6386
Mailing Address - Fax:
Practice Address - Street 1:14 TELFORD LN
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3323
Practice Address - Country:US
Practice Address - Phone:856-235-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101424800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist