Provider Demographics
NPI:1114258522
Name:CROWE, MICHAEL WILLIAM (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:CROWE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 E 2ND AVE
Mailing Address - Street 2:SUITE 806
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-2010
Mailing Address - Country:US
Mailing Address - Phone:810-214-0728
Mailing Address - Fax:810-496-4296
Practice Address - Street 1:607 E 2ND AVE
Practice Address - Street 2:SUITE 806
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-2010
Practice Address - Country:US
Practice Address - Phone:810-214-0728
Practice Address - Fax:810-496-4296
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist