Provider Demographics
NPI:1942713581
Name:WALDRON, SYLVIA CHRISTY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:CHRISTY
Last Name:WALDRON
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 1:10 BRADFORD CT
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4169
Mailing Address - Country:US
Mailing Address - Phone:269-271-3240
Mailing Address - Fax:
Practice Address - Street 1:75 S DEXTER ST
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-9071
Practice Address - Country:US
Practice Address - Phone:734-878-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302041600OtherSTATE OF MICHIGAN PHARMACIST LICENSE