Provider Demographics
NPI:1497805469
Name:DREWYOR, MICHAEL THOMAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:DREWYOR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 N REPUBLIC BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1524
Mailing Address - Country:US
Mailing Address - Phone:419-841-6256
Mailing Address - Fax:419-841-5924
Practice Address - Street 1:3150 N REPUBLIC BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1524
Practice Address - Country:US
Practice Address - Phone:419-841-6256
Practice Address - Fax:419-841-5924
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4747103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical