MEDICARE: MR. MELVIN TERRY

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	14495	MD

General Provider Information

NPI Number	:	1457651127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MELVIN TERRY

Provider Business Mailing Address
First Line	:	5800 SILVER HILL RD
Second Line	:
City	:	DISTRICT HTS
State	:	MD
Zip	:	20747-1103
Country	:	US
Telephone Number	:	301-568-2233
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 SILVER HILL RD
Second Line	:
City	:	DISTRICT HTS
State	:	MD
Zip	:	20747-1103
Country	:	US
Telephone Number	:	301-568-2233
Fax Number	:

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

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	10/28/2010

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Directions to “ MR. MELVIN TERRY ” Practice Location

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