Provider Demographics
NPI:1669553434
Name:STUTLER, MICHELLE DAWN (RPH)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:DAWN
Last Name:STUTLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8787 BROOKPARK RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-6809
Mailing Address - Country:US
Mailing Address - Phone:216-739-7000
Mailing Address - Fax:
Practice Address - Street 1:8787 BROOKPARK RD # 119P
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6809
Practice Address - Country:US
Practice Address - Phone:162-739-7000
Practice Address - Fax:216-229-2596
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-22783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist