MEDICARE: SAMUEL I KUTI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11128	MD

General Provider Information

NPI Number	:	1093896060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL I KUTI

Provider Business Mailing Address
First Line	:	808 DARIEN PL
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5733
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3611 BRANCH AVE
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1242
Country	:	US
Telephone Number	:	301-423-8070
Fax Number	:	301-423-7707

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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Directions to “ SAMUEL I KUTI ” Practice Location

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