DR. MAYA ANGELA TATUM (NPI# 1639448426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639448426 |
| Entity Type | Individual |
| Full Name | DR. MAYA ANGELA TATUM |
| Credential | PHARMD |
| Practice Address |
701 N Wales Rd North Wales PA 19454-2754 |
| Mailing Address |
624 S Clifton St Philadelphia PA 19147-1921 |
| Practice Telephone | 2154128709 |
| Mailing Telephone | 2677738651 |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPI005647 | PA | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RP441117 | PA | Pharmacy Service Providers |
| Street Address |
701 N WALES RD |
| City | NORTH WALES |
| State | PA |
| Zip Code | 19454-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295258960 | Stephanie Dalzon | Contractor | 700 Lower State Rd Apt Th20, North Wales, PA 19454 | 2017-07-24 |
| 1457723611 | Stacey Kirchein | Dietitian, Registered | 700 Lower State Rd, Apt 18a1, North Wales, PA 19454 | 2015-10-28 |
| 1902289713 | Nani Rivera-cox | Marriage & Family Therapist | 217 Church Road, North Wales, PA 19454 | 2015-06-30 |
| 1104254812 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 167 Montgomery Mall, North Wales, PA 19454 | 2013-10-16 |
| 1023367323 | Wholistics / Wholistic Fitness LLC | Psychologist | 217 Church Rd Suite B, North Wales, PA 19454 | 2012-08-31 |
| 1396075925 | Mary M Oconnor | Occupational Therapist | 102 West Walnut St., North Wales Hand Rehabilitation, North Wales, PA 19454 | 2010-01-04 |
| 1104155050 | Laurie F Langbein | Counselor | 101 Chamberlain Cir, North Wales, PA 19454 | 2009-12-23 |
| 1235397225 | Jennifer Gail Duncan | Dentist | 298 Wissahickon Avenue, Suite 3, North Wales, PA 19454 | 2008-05-28 |
| 1811101967 | Angel Wahib Elbardissi | Dentist | 210 Stump Rd, North Wales, PA 19454 | 2007-05-09 |
| 1336361963 | Arlene M. Lavner | Counselor | 1233 Laura Lane, North Wales, PA 19454 | 2007-05-03 |
| Find all providers in zip 19454 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466780 | Rhonda Sue Wible | Pharmacist | 134 Overlook Dr, Franklin, PA 16323-4412 | 2020-10-28 |
| 1235743170 | Himaswetha Bharatha | Pharmacist | 5610 Derry St, Harrisburg, PA 17111-3518 | 2020-09-08 |
| 1295355030 | Nur Kazzaz | Pharmacist | 3401 N Broad St Ste B150, Philadelphia, PA 19140-5103 | 2020-04-22 |
| 1659900728 | Joseph Paul Nemetz | Pharmacist | 738 Shady Ave, Sharon, PA 16146-3149 | 2020-04-02 |
| 1437786969 | Leah Marron Rapp | Pharmacist | 30 Pinnacle Dr Ste 103, Clarion, PA 16214-3800 | 2020-03-25 |
| 1437780913 | Peter Hallisey | Pharmacist | 565 Coal Valley Rd Dept Of, Clairton, PA 15025-3703 | 2020-02-03 |
| 1467013292 | Kelly Rose Sones | Pharmacist | 58/60 Public Square, Wilkes-barre, PA 18702 | 2019-06-24 |
| 1851865000 | Hanh Pham-nguyen | Pharmacist | 260 Wilson Ave, Hanover, PA 17331 | 2019-01-21 |
| 1033693270 | Eric Abanquah | Pharmacist | 120 Fifth Avenue, Fap-1456, Pittsburgh, PA 15222 | 2018-09-24 |
| 1164903381 | Suzanne Scott Giyanani | Pharmacist | 200 W Washington Sq Apt 3609, Philadelphia, PA 19106-3538 | 2018-08-25 |
| Find all providers with the same taxonomy | ||||
| City | NORTH WALES |
| Zip Code | 19454 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.