Provider Demographics
NPI:1629360888
Name:SAAVEDRA, MICHAEL DANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL DANE
Middle Name:
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15940 CHANNEL POINT DR
Mailing Address - Street 2:
Mailing Address - City:SALE CREEK
Mailing Address - State:TN
Mailing Address - Zip Code:37373-7906
Mailing Address - Country:US
Mailing Address - Phone:352-219-2216
Mailing Address - Fax:423-697-7593
Practice Address - Street 1:3569 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-2708
Practice Address - Country:US
Practice Address - Phone:352-219-2216
Practice Address - Fax:423-697-7593
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI27646390200000X
TN0000039733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program