Provider Demographics
NPI:1538469606
Name:GEARHART, MELVIN ANTHONY
Entity Type:Individual
Prefix:
First Name:MELVIN
Middle Name:ANTHONY
Last Name:GEARHART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 PINECROFT CT
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1032
Mailing Address - Country:US
Mailing Address - Phone:410-305-1262
Mailing Address - Fax:
Practice Address - Street 1:7643 ARUNDEL MILLS BLVD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1305
Practice Address - Country:US
Practice Address - Phone:410-904-7227
Practice Address - Fax:410-904-7226
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist