MEDICARE: MR. MICHAEL J SHIBER RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	RP040815L	PA

General Provider Information

NPI Number	:	1053431304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL J SHIBER RPH

Provider Business Mailing Address
First Line	:	19830 DAWSON CEMETERY RD
Second Line	:
City	:	RAWLINGS
State	:	MD
Zip	:	21557-1904
Country	:	US
Telephone Number	:	301-786-4859
Fax Number	:	301-786-4859

Provider Business Practice Location Address
First Line	:	19830 DAWSON CEMETERY RD
Second Line	:
City	:	RAWLINGS
State	:	MD
Zip	:	21557-1904
Country	:	US
Telephone Number	:	301-786-4859
Fax Number	:	301-786-4859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	07/08/2007

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