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General NPI Number Information
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NPI Number | 1275185415
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Entity Type | Individual
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Provider Name | MATTHEW GILBERT RPH
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Gender | Male
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 7157 E SAGINAW ST
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City | EAST LANSING
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State | MI
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Zip | 48823-9620
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Country | US
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Telephone | 517-885-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 383 SHOESMITH RD
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City | HASLETT
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State | MI
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Zip | 48840-9790
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Country | US
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Telephone | 517-775-6600
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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 | 5302033363
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License Number State | MI
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