Provider Demographics
NPI:1083239909
Name:MAY, MITCHELL GREGORY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:GREGORY
Last Name:MAY
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 1:5088 LONG RAPIDS RD
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-9781
Mailing Address - Country:US
Mailing Address - Phone:989-464-0256
Mailing Address - Fax:
Practice Address - Street 1:1011 M 32 W
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-8169
Practice Address - Country:US
Practice Address - Phone:989-354-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315096849OtherMICHIGAN PHARMACIST CONTROLLED SUBSTANCE LICENSE
884665OtherNABP IDENTIFICATION NUMBER
MI5302040568OtherMICHIGAN PHARMACIST LICENSE