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General NPI Number Information
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NPI Number | 1952679342
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Entity Type | Individual
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Provider Name | EVAN BRYCE WEARNE PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 1511 HEATHER HOLLOW CIR APT 21
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City | SILVER SPRING
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State | MD
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Zip | 20904-2351
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Country | US
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Telephone | 308-641-0879
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Fax | 301-431-6356
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Provider Business Mailing Address
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Address Line | 1511 HEATHER HOLLOW CIR APT 21
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City | SILVER SPRING
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State | MD
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Zip | 20904-2351
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Country | US
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Telephone | 308-641-0879
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Fax | 301-431-6356
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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 | 13125
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License Number State | NE
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