Provider Demographics
NPI:1760475883
Name:THOMAS, MICHELLE HERBERT (PHARMD, RPH, CDE)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:HERBERT
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD, RPH, CDE
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:CORRIN
Other - Last Name:HERBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, CDE
Mailing Address - Street 1:4630 S LABURNUM AVE
Mailing Address - Street 2:STE B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2424
Mailing Address - Country:US
Mailing Address - Phone:804-932-4388
Mailing Address - Fax:804-932-1003
Practice Address - Street 1:1850 POCAHONTAS TRL
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1657
Practice Address - Country:US
Practice Address - Phone:804-932-4388
Practice Address - Fax:804-932-1003
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02020100591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist