Ted Tristan Nussbaum, RPH Valid NPI

Individual provider · Pharmacist · Moncks Corner, SC

NPI

1497052666

Type

Individual (Type 1)

Primary specialty

Pharmacist

Specialty group

Pharmacy Service Providers

Taxonomy code

183500000X

License number

11560 (SC)

Sex

Male

Sole proprietor

No

Enumerated

2011-02-23

Last updated

2025-06-10