Provider Demographics
NPI:1861787491
Name:ESTEP, MELODY RYAN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:RYAN
Last Name:ESTEP
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MAMIE FERGUSON DR
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-6642
Mailing Address - Country:US
Mailing Address - Phone:910-814-2758
Mailing Address - Fax:
Practice Address - Street 1:1137 N BRAGG BLVD
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-3116
Practice Address - Country:US
Practice Address - Phone:910-436-0040
Practice Address - Fax:910-495-0137
Is Sole Proprietor?:No
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist