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General NPI Number Information
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NPI Number | 1740969435
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Entity Type | Individual
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Provider Name | KYLE WESSELMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 2001 MEDICAL PKWY
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3773
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Country | US
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Telephone | 443-481-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 5242 KERGER RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-7012
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Country | US
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Telephone | 410-428-2332
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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 | 29267
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License Number State | MD
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