Provider Demographics
NPI:1922575273
Name:OISTEN, MICHAEL ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:OISTEN
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 1:1561 WOODHILL CT SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-5041
Mailing Address - Country:US
Mailing Address - Phone:616-826-5001
Mailing Address - Fax:
Practice Address - Street 1:56151 M 51 S
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-9762
Practice Address - Country:US
Practice Address - Phone:269-782-4511
Practice Address - Fax:269-782-9899
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302411995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist