Provider Demographics
NPI:1073807814
Name:MOLNAR, ANDREA M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:MOLNAR
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 1:14099 PARDEE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4792
Mailing Address - Country:US
Mailing Address - Phone:734-288-0005
Mailing Address - Fax:734-286-9638
Practice Address - Street 1:14099 PARDEE RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4792
Practice Address - Country:US
Practice Address - Phone:734-288-0005
Practice Address - Fax:734-286-9638
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist