Healthcare Provider Details

I. General information

NPI: 1124603147
Provider Name (Legal Business Name): MICHAEL L SPINNER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

7307 GATEWAY CT
CLEVELAND OH
44102-2086
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-4408
  • Fax:
Mailing address:
  • Phone: 216-678-6642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0323355
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: