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General NPI Number Information
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NPI Number | 1629372099
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD CAUTHEN R. PH.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 8101 KENSINGTON DR
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City | WAXHAW
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State | NC
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Zip | 28173-0103
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Country | US
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Telephone | 704-843-7131
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Fax |
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Provider Business Mailing Address
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Address Line | 1312 SOMERSET DR
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City | LANCASTER
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State | SC
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Zip | 29720-1719
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Country | US
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Telephone | 803-285-1227
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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 | 12471
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License Number State | NC
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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 | 4639
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License Number State | SC
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