Healthcare Provider Details

I. General information

NPI: 1245861830
Provider Name (Legal Business Name): DANIELLE EVELYN NMAIR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2020
Last Update Date: 02/01/2020
Certification Date: 02/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21777 21 MILE RD
MACOMB MI
48044-2962
US

IV. Provider business mailing address

38938 SANTA BARBARA ST
CLINTON TWP MI
48036-4026
US

V. Phone/Fax

Practice location:
  • Phone: 586-949-2082
  • Fax:
Mailing address:
  • Phone: 586-242-6665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302035754
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: