Provider Demographics
NPI:1700481041
Name:MEDER, MARIA
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MEDER
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 FAIR WINDS WAY
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1193
Mailing Address - Country:US
Mailing Address - Phone:301-341-4100
Mailing Address - Fax:
Practice Address - Street 1:8301 PROFESSIONAL PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2237
Practice Address - Country:US
Practice Address - Phone:301-341-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty