Provider Demographics
NPI:1477700748
Name:KELSCH, MICHAEL P (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:KELSCH
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118G SUDRO HALL
Mailing Address - Street 2:NORTH DAKOTA STATE UNIVERSITY
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58105-5055
Mailing Address - Country:US
Mailing Address - Phone:701-231-6528
Mailing Address - Fax:701-231-7606
Practice Address - Street 1:118G SUDRO HALL
Practice Address - Street 2:NORTH DAKOTA STATE UNIVERSITY
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58105-5055
Practice Address - Country:US
Practice Address - Phone:701-231-6528
Practice Address - Fax:701-231-7606
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND47631835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy