Provider Demographics
NPI:1184951808
Name:BALL, MICHAEL ALAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:BALL
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 1:4620 WOODY MILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8779
Mailing Address - Country:US
Mailing Address - Phone:336-674-5518
Mailing Address - Fax:336-674-5590
Practice Address - Street 1:4620 WOODY MILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8779
Practice Address - Country:US
Practice Address - Phone:336-674-5518
Practice Address - Fax:336-674-5590
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist