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NPI Code Detail

MEDICARE: MICHAEL MASIN

MEDICARE: MICHAEL MASIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03136004OH

General Provider Information

NPI Number : 1306441951
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MASIN
Provider Business Mailing Address
First Line : 1991 PERSIMMON WAY APT 1B
Second Line :
City : TIPP CITY
State : OH
Zip : 45371-7565
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5700 EXECUTIVE BLVD
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-1449
Country : US
Telephone Number : 937-233-4133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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Directions to “ MICHAEL MASIN ” Practice Location

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