Provider Demographics
NPI:1891194296
Name:SCALESE, MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SCALESE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CLINIC DR
Mailing Address - Street 2:ROOM 2100
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36688-0001
Mailing Address - Country:US
Mailing Address - Phone:251-445-9318
Mailing Address - Fax:
Practice Address - Street 1:650 CLINIC DR
Practice Address - Street 2:ROOM 2100
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36688-0001
Practice Address - Country:US
Practice Address - Phone:251-445-9318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL179101835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist