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General NPI Number Information
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NPI Number | 1194384917
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Entity Type | Individual
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Provider Name | MICHELE DAWSON OVERTOOM DOCTOR OF PHARMACY
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Gender | Female
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | WEGMANS PHARMACY #125 10100 REISTERSTOWN ROAD
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City | OWINGS MILLS
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State | MD
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Zip | 21117
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Country | US
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Telephone | 443-491-2345
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Fax | 443-491-2398
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Provider Business Mailing Address
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Address Line | 19535 MIDDLETOWN RD
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City | FREELAND
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State | MD
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Zip | 21053-9406
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Country | US
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Telephone | 410-375-4827
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Fax | 443-491-3854
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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 | 11746
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License Number State | MD
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