Provider Demographics
NPI:1629112248
Name:MCPIKE, STEPHEN CLAYTON (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:CLAYTON
Last Name:MCPIKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-9632
Mailing Address - Country:US
Mailing Address - Phone:207-654-2114
Mailing Address - Fax:
Practice Address - Street 1:15 WILDWOOD LN
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-9632
Practice Address - Country:US
Practice Address - Phone:207-654-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist