Provider Demographics
NPI:1639422090
Name:OBIRI, DORIS N (RPH)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:N
Last Name:OBIRI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 N MISSION ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1001
Mailing Address - Country:US
Mailing Address - Phone:989-772-0291
Mailing Address - Fax:
Practice Address - Street 1:903 N MISSION ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1001
Practice Address - Country:US
Practice Address - Phone:989-772-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032727183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist