MEDICARE: DR. AMANDA MICHELLE MCDONALD PHARM D

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	5302037257	MI

General Provider Information

NPI Number	:	1821382847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA MICHELLE MCDONALD PHARM D

Provider Business Mailing Address
First Line	:	500 E EDGEWOOD BLVD
Second Line	:	T-0361
City	:	LANSING
State	:	MI
Zip	:	48911-5901
Country	:	US
Telephone Number	:	517-882-4845
Fax Number	:	517-882-4845

Provider Business Practice Location Address
First Line	:	500 E EDGEWOOD BLVD
Second Line	:	T-0361
City	:	LANSING
State	:	MI
Zip	:	48911-5901
Country	:	US
Telephone Number	:	517-882-4845
Fax Number	:	517-882-4845

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

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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