Provider Demographics
NPI:1730778077
Name:ANDREWS, MICHAEL WADE (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WADE
Last Name:ANDREWS
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 1:1566 HOPEWELL RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-4436
Mailing Address - Country:US
Mailing Address - Phone:270-227-6065
Mailing Address - Fax:
Practice Address - Street 1:604 S 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2916
Practice Address - Country:US
Practice Address - Phone:270-753-7688
Practice Address - Fax:270-753-6782
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist