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General NPI Number Information
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NPI Number | 1073113049
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Entity Type | Individual
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Provider Name | WAYNE ALDEN DYKE RPH
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Gender | Male
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 9750 REISTERSTOWN RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4147
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Country | US
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Telephone | 443-394-0987
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Fax | 443-394-0970
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Provider Business Mailing Address
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Address Line | 900 FARMSTEAD RD
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-2816
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Country | US
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Telephone | 443-750-1111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 06991
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License Number State | MD
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