Provider Demographics
NPI:1073593547
Name:MCMICHAEL, ANGELA AIKENS (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:AIKENS
Last Name:MCMICHAEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6013 GLORYVINE DR
Mailing Address - Street 2:APT # 202
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6920
Mailing Address - Country:US
Mailing Address - Phone:804-275-2780
Mailing Address - Fax:
Practice Address - Street 1:23617 WEST WASHINGTON ST.
Practice Address - Street 2:BUILDING 10
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803
Practice Address - Country:US
Practice Address - Phone:804-524-7744
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207175183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist