Individual
DR. MICHAEL JESSE VERDUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., MS
Contact information
Practice address
283 HAYBINE DRIVE, SHENANDOAH JUNCTION, WV 25442
(520) 440-6396
Mailing address
283 HAYBINE DRIVE, SHENANDOAH JUNCTION, WV 25442
(520) 440-6396
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LASAC-15283
AZ
183500000X
Pharmacist
119588
MN
183500000X
Pharmacist
12494
AZ
183500000X
Pharmacist
51262
CA
183500000X
Pharmacist
6179
WV
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
APH-10147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119588
PHARMACIST LICENSE
MN
01
—
12494
PHARMACIST LICENSE
AZ
05
—
474690000
—
MN
01
—
51262
PHARMACIST LICENSE
CA
01
—
6179
PHARMACIST LICENSE
WV
01
—
APH-10147
ADVANCED PRACTICE PHARMACIST LICENSE
CA
01
—
LASAC-15283
ASSOCIATE SUBSTANCE ABUSE COUNSELOR
AZ
Enumeration date
09/29/2006
Last updated
09/28/2019
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