Provider Demographics
NPI:1811029127
Name:COLE, ANTHONY JAMES (PHARMD MPH MBA RPH)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAMES
Last Name:COLE
Suffix:
Gender:M
Credentials:PHARMD MPH MBA RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18021 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1627
Mailing Address - Country:US
Mailing Address - Phone:313-368-1000
Mailing Address - Fax:313-368-1068
Practice Address - Street 1:18021 CONANT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1627
Practice Address - Country:US
Practice Address - Phone:313-368-1000
Practice Address - Fax:313-368-1068
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist