Healthcare Provider Details

I. General information

NPI: 1790195329
Provider Name (Legal Business Name): PAULA SPEAR PHARM.D, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30800 LITTLE MACK AVE
ROSEVILLE MI
48066-1700
US

IV. Provider business mailing address

13546 MAIR DR
STERLING HEIGHTS MI
48313-2653
US

V. Phone/Fax

Practice location:
  • Phone: 586-415-6164
  • Fax: 586-415-6165
Mailing address:
  • Phone: 586-665-1672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302032063
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: