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General NPI Number Information
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NPI Number | 1972991768
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Entity Type | Individual
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Provider Name | MICHAEL EVENSON PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/31/2014
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 10073 E HIGHLAND RD
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City | HOWELL
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State | MI
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Zip | 48843-1367
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Country | US
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Telephone | 810-632-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 3865 SNOWDEN LN
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City | HOWELL
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State | MI
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Zip | 48843-8639
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Country | US
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Telephone | 248-770-7617
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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 | 5302040311
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License Number State | MI
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