NPI 1609379726 · live from the CMS NPI Registry
Michael Bolan
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fort Wainwright, AK. National Provider Identifier 1609379726, active.
NPI record
| NPI | 1609379726 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X |
| Practice location | 4076 Neely Road, Fort Wainwright, AK 99709 |
| Practice phone | 907-361-5109 |
| Mailing address | 3010 Davis Rd Apt B3, Fairbanks, AK 99709 |
| Enumerated | March 15, 2018 |
| Last updated | March 15, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist primary | 1835P0018X | 03236558 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.