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NPI Code Detail

MEDICARE: BLAKE THOMAS SHIFLETT

MEDICARE: BLAKE THOMAS SHIFLETT
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
1183500000XPharmacist5302411902MI

General Provider Information

NPI Number : 1649881624
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLAKE THOMAS SHIFLETT
Provider Business Mailing Address
First Line : 571 S MAIN ST
Second Line :
City : LAPEER
State : MI
Zip : 48446-2466
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 571 S MAIN ST
Second Line :
City : LAPEER
State : MI
Zip : 48446-2466
Country : US
Telephone Number : 810-538-0014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2020
Last Update Date : 08/12/2020

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Directions to “ BLAKE THOMAS SHIFLETT ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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