Provider Demographics
NPI:1215552070
Name:DAVIS, MICHELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DAVIS
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 1:479 DELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-2907
Mailing Address - Country:US
Mailing Address - Phone:828-452-2313
Mailing Address - Fax:828-452-5451
Practice Address - Street 1:479 DELLWOOD RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2907
Practice Address - Country:US
Practice Address - Phone:828-452-2313
Practice Address - Fax:828-452-5451
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist