Provider Demographics
NPI:1952733164
Name:CAVANA, MARIJA MIKULSKIS (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:MARIJA
Middle Name:MIKULSKIS
Last Name:CAVANA
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11109 US HIGHWAY 15 501
Mailing Address - Street 2:UNIT 1804
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2366
Mailing Address - Country:US
Mailing Address - Phone:910-692-3048
Mailing Address - Fax:910-692-3321
Practice Address - Street 1:11109 US HIGHWAY 15 501
Practice Address - Street 2:UNIT 1804
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2366
Practice Address - Country:US
Practice Address - Phone:910-692-3048
Practice Address - Fax:910-692-3321
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC22495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist