Provider Demographics
NPI:1003185117
Name:SMITH, MICHAEL SHAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SHAY
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30957 MILL LN
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5453
Mailing Address - Country:US
Mailing Address - Phone:251-625-4654
Mailing Address - Fax:251-625-4774
Practice Address - Street 1:30957 MILL LN
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5453
Practice Address - Country:US
Practice Address - Phone:251-625-4654
Practice Address - Fax:251-625-4774
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist