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General NPI Number Information
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NPI Number | 1538547682
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Entity Type | Individual
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Provider Name | MICHAEL CORVINO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2015
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 51 NASSAU ST
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City | CHARLESTON
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State | SC
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Zip | 29403-5513
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Country | US
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Telephone | 843-720-5655
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Fax |
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Provider Business Mailing Address
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Address Line | 1949 CLAY LN
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City | CHARLESTON
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State | SC
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Zip | 29414-6680
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Country | US
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Telephone | 843-870-4004
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 36021
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License Number State | SC
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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 | 36021
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License Number State | SC
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