MEDICARE: MELVIN ATUEYI

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	22699	MD

General Provider Information

NPI Number	:	1871992420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN ATUEYI

Provider Business Mailing Address
First Line	:	14 VIVIAN VALE CT
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-4310
Country	:	US
Telephone Number	:	443-983-6280
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 BELAIR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1203
Country	:	US
Telephone Number	:	410-522-3843
Fax Number	:

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

Provider Enumeration Date	:	08/20/2014
Last Update Date	:	08/20/2014

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Directions to “ MELVIN ATUEYI ” Practice Location

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