Provider Demographics
NPI:1669610507
Name:MCDONALD, MICHAEL ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11405 DUNMAGLAS DR
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:MI
Mailing Address - Zip Code:48808-9303
Mailing Address - Country:US
Mailing Address - Phone:517-410-6457
Mailing Address - Fax:800-394-4810
Practice Address - Street 1:11405 DUNMAGLAS DR
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:MI
Practice Address - Zip Code:48808-9303
Practice Address - Country:US
Practice Address - Phone:517-410-6457
Practice Address - Fax:800-394-4810
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020318861835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist