Provider Demographics
NPI:1861510331
Name:GIRARD, MIKEL COLE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MIKEL
Middle Name:COLE
Last Name:GIRARD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 KING FREDRICK LN
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-0403
Mailing Address - Country:US
Mailing Address - Phone:704-644-1942
Mailing Address - Fax:
Practice Address - Street 1:30 WARREN C COLEMAN BLVD N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8318
Practice Address - Country:US
Practice Address - Phone:704-782-2142
Practice Address - Fax:704-786-2923
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist