Provider Demographics
NPI:1457673725
Name:RAY, MICHAEL STEVEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:RAY
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 1:4480 INDIAN RIPPLE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3252
Mailing Address - Country:US
Mailing Address - Phone:937-426-3952
Mailing Address - Fax:
Practice Address - Street 1:4480 INDIAN RIPPLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-3252
Practice Address - Country:US
Practice Address - Phone:937-426-3952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031-13487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist