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General NPI Number Information
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NPI Number | 1962168302
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Entity Type | Individual
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Provider Name | RYAN MEDVED PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0004
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Country | US
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Telephone | 301-295-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 8205 PERIDOT DR UNIT 103
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City | TYSONS CORNER
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State | VA
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Zip | 22102-3962
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Country | US
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Telephone | 770-658-6119
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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 | 37361
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License Number State | SC
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