MEDICARE: MELVIN ANTHONY GEARHART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11766	MD

General Provider Information

NPI Number	:	1538469606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN ANTHONY GEARHART

Provider Business Mailing Address
First Line	:	2012 PINECROFT CT
Second Line	:
City	:	ODENTON
State	:	MD
Zip	:	21113-1032
Country	:	US
Telephone Number	:	410-305-1262
Fax Number	:

Provider Business Practice Location Address
First Line	:	7643 ARUNDEL MILLS BLVD
Second Line	:
City	:	HANOVER
State	:	MD
Zip	:	21076-1305
Country	:	US
Telephone Number	:	410-904-7227
Fax Number	:	410-904-7226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2010
Last Update Date	:	10/23/2010

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