Provider Demographics
NPI:1437428125
Name:DONOHUE, MICHAEL JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 STILL WOODS LN
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-8954
Mailing Address - Country:US
Mailing Address - Phone:828-883-4432
Mailing Address - Fax:
Practice Address - Street 1:623 SPARTANBURG HWY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5762
Practice Address - Country:US
Practice Address - Phone:828-697-2231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-25
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17440183500000X
VT33-0003039183500000X
CO13105183500000X
NY038095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist