Provider Demographics
NPI:1568080935
Name:CHARRON, MAX
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:CHARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-4280
Mailing Address - Country:US
Mailing Address - Phone:989-753-9688
Mailing Address - Fax:
Practice Address - Street 1:3730 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-4280
Practice Address - Country:US
Practice Address - Phone:989-753-9688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-11
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist