Provider Demographics
NPI:1275935488
Name:GROVES, CARMELA NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARMELA
Middle Name:NICOLE
Last Name:GROVES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7255 SWAN POINT WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5052
Mailing Address - Country:US
Mailing Address - Phone:410-707-5675
Mailing Address - Fax:
Practice Address - Street 1:2801 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3862
Practice Address - Country:US
Practice Address - Phone:410-732-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist