MEDICARE: MICHAEL DUFFIN PHARMD

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	183500000X	Pharmacist	RP940440	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255764460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DUFFIN PHARMD

Provider Business Mailing Address
First Line	:	146 BILLOWS DR.
Second Line	:
City	:	MT. ROYAL
State	:	NJ
Zip	:	08061
Country	:	US
Telephone Number	:	484-716-4649
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 BILLOWS DR.
Second Line	:
City	:	MOUNT ROYAL
State	:	NJ
Zip	:	08061
Country	:	US
Telephone Number	:	484-716-4649
Fax Number	:

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

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	08/12/2013

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