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General NPI Number Information
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NPI Number | 1043594278
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Entity Type | Individual
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Provider Name | MICHAEL RAIS RPH
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Gender | Male
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 15121 24 MILE RD
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City | SHELBY TWP
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State | MI
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Zip | 48315-2109
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Country | US
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Telephone | 586-677-4015
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Fax | 586-677-4024
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Provider Business Mailing Address
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Address Line | 42480 BEECHWOOD DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-2944
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Country | US
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Telephone | 586-580-2002
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Fax | 586-580-2021
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302028656
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License Number State | MI
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