Provider Demographics
NPI:1336278944
Name:LOPOUR, MICHAEL WARREN (PHARMD MBA)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WARREN
Last Name:LOPOUR
Suffix:
Gender:M
Credentials:PHARMD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 S 23RD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-5361
Mailing Address - Country:US
Mailing Address - Phone:480-661-2215
Mailing Address - Fax:480-314-6983
Practice Address - Street 1:9501 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6719
Practice Address - Country:US
Practice Address - Phone:480-661-2215
Practice Address - Fax:480-314-6983
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist