Healthcare Provider Details

I. General information

NPI: 1538758214
Provider Name (Legal Business Name): EDIMA MCHETZ PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GREENE ST
BALTIMORE MD
21201-1524
US

IV. Provider business mailing address

10 N GREENE ST
BALTIMORE MD
21201-1524
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7000
  • Fax: 410-605-7781
Mailing address:
  • Phone: 410-605-7000
  • Fax: 410-605-7781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number1538758214
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: