Healthcare Provider Details

I. General information

NPI: 1184911042
Provider Name (Legal Business Name): MICHAEL SANT SEKHON STUDENT PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MOUNT ROYAL BLVD
PITTSBURGH PA
15223-1060
US

IV. Provider business mailing address

4491 HILTY RD
MURRYSVILLE PA
15668-9315
US

V. Phone/Fax

Practice location:
  • Phone: 412-487-5706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPI111710
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: