Provider Demographics
NPI:1841417953
Name:SPURLOCK, MICHELLE MONROE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MONROE
Last Name:SPURLOCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9144 BROCKLEHURST LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8704
Mailing Address - Country:US
Mailing Address - Phone:704-535-3996
Mailing Address - Fax:
Practice Address - Street 1:9740 UNIVERSITY CITY BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3608
Practice Address - Country:US
Practice Address - Phone:704-688-5330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist