Provider Demographics
NPI:1598944407
Name:NEAREY, KEVIN MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:NEAREY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 LISBON CENTER DR STE D
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797-8629
Mailing Address - Country:US
Mailing Address - Phone:410-489-2708
Mailing Address - Fax:410-489-2762
Practice Address - Street 1:710 LISBON CENTER DR STE D
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797-8629
Practice Address - Country:US
Practice Address - Phone:410-489-2708
Practice Address - Fax:410-489-2762
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist