Provider Demographics
NPI:1578642765
Name:SPELLMAN, JAIME CATHERINE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:CATHERINE
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:JAIME
Other - Middle Name:CATHERINE
Other - Last Name:POMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4000 HIGHLAND RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2167
Mailing Address - Country:US
Mailing Address - Phone:866-850-6567
Mailing Address - Fax:
Practice Address - Street 1:4000 HIGHLAND RD
Practice Address - Street 2:SUITE 113
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2167
Practice Address - Country:US
Practice Address - Phone:866-850-6567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020335951835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy