Provider Demographics
NPI:1205833290
Name:OPPONG, MICHELLE D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:D
Last Name:OPPONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4752 IVY RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6628
Mailing Address - Country:US
Mailing Address - Phone:404-277-6295
Mailing Address - Fax:866-430-8387
Practice Address - Street 1:55 IVAN ALLEN JR BLVD NW
Practice Address - Street 2:HEALTH SCIENCE ADVISORY SERVICES
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3050
Practice Address - Country:US
Practice Address - Phone:404-616-0134
Practice Address - Fax:404-616-6070
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist