Provider Demographics
NPI:1679020945
Name:EWUSIE-MONNEY, RICHARD
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:EWUSIE-MONNEY
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 1:504 SUNNY BROOK TER
Mailing Address - Street 2:APT # 932
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-4343
Mailing Address - Country:US
Mailing Address - Phone:856-842-8780
Mailing Address - Fax:
Practice Address - Street 1:19100 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3701
Practice Address - Country:US
Practice Address - Phone:301-948-6886
Practice Address - Fax:301-947-2362
Is Sole Proprietor?:No
Enumeration Date:2016-09-05
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist