MEDICARE: MORRIETTA KWEKEH

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	T2593	MD

General Provider Information

NPI Number	:	1730803032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORRIETTA KWEKEH

Provider Business Mailing Address
First Line	:	24 DEERLODGE CT APT J
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-3854
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10825 BIRMINGHAM WAY
Second Line	:
City	:	WOODSTOCK
State	:	MD
Zip	:	21163-1427
Country	:	US
Telephone Number	:	410-461-7547
Fax Number	:

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

Provider Enumeration Date	:	09/29/2022
Last Update Date	:	09/29/2022

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Directions to “ MORRIETTA KWEKEH ” Practice Location

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