Provider Demographics
NPI:1346843455
Name:ADAMS- GUEVARA, MELLISA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELLISA
Middle Name:
Last Name:ADAMS- GUEVARA
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 1:4201 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-4805
Mailing Address - Country:US
Mailing Address - Phone:540-786-3008
Mailing Address - Fax:540-786-1931
Practice Address - Street 1:4201 PLANK RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4805
Practice Address - Country:US
Practice Address - Phone:540-786-3008
Practice Address - Fax:540-786-1931
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist