MEDICARE: DR. STEPHEN A MASLEID RPH PHARMD

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	26021868A	IN

General Provider Information

NPI Number	:	1417230616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN A MASLEID RPH PHARMD

Provider Business Mailing Address
First Line	:	14327 DELANEY DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-5283
Country	:	US
Telephone Number	:	765-532-2433
Fax Number	:

Provider Business Practice Location Address
First Line	:	13741 E 116TH ST
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-7604
Country	:	US
Telephone Number	:	317-595-8764
Fax Number	:	317-595-8831

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

Provider Enumeration Date	:	09/23/2011
Last Update Date	:	09/23/2011

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