Provider Demographics
NPI:1598073447
Name:EDGERTON, MICHAEL CRAIG (PHARMD, RPH, BS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CRAIG
Last Name:EDGERTON
Suffix:
Gender:M
Credentials:PHARMD, RPH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 CAROLINA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2703
Mailing Address - Country:US
Mailing Address - Phone:910-422-4300
Mailing Address - Fax:
Practice Address - Street 1:5900 CAROLINA BEACH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2703
Practice Address - Country:US
Practice Address - Phone:910-422-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist