Healthcare Provider Details

I. General information

NPI: 1124150776
Provider Name (Legal Business Name): MICHAEL FAITHE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 ALBION ST APT 212
DENVER CO
80220-2366
US

IV. Provider business mailing address

1175 ALBION ST APT 212
DENVER CO
80220-2366
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax:
Mailing address:
  • Phone: 303-399-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00006888
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: