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General NPI Number Information
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NPI Number | 1184246589
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Entity Type | Individual
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Provider Name | MICHELLE J MIKUS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 100 PARK MANOR DR
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City | PITTSBURGH
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State | PA
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Zip | 15205-1012
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Country | US
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Telephone | 724-414-1425
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Fax |
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Provider Business Mailing Address
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Address Line | 548 THORNCLIFFE DR
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City | PITTSBURGH
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State | PA
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Zip | 15205-1532
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Country | US
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Telephone | 412-403-4301
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Fax |
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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 | 03233406
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0010640
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP448182
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License Number State | PA
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