Provider Demographics
NPI:1366726036
Name:BIERLY, MICHAEL G (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:G
Last Name:BIERLY
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 1:35804 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1681
Mailing Address - Country:US
Mailing Address - Phone:440-930-0102
Mailing Address - Fax:440-930-0123
Practice Address - Street 1:35804 DETROIT RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1681
Practice Address - Country:US
Practice Address - Phone:440-930-0102
Practice Address - Fax:440-930-0123
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03221199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03221199OtherPHARMACIST IDENTIFICATION NUMBER