Provider Demographics
NPI:1801934468
Name:NEACE, MICHAEL LEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:NEACE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:LEE
Other - Last Name:BAXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2 BERNARDINE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4404
Mailing Address - Country:US
Mailing Address - Phone:757-886-6175
Mailing Address - Fax:
Practice Address - Street 1:2 BERNARDINE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4404
Practice Address - Country:US
Practice Address - Phone:757-886-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC148601835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy