Individual
MICHAEL R MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 HWY 138, STOUGHTON, WI 53589
(608) 873-9262
(608) 873-5496
Mailing address
6610 COOPER AVE, MIDDLETON, WI 53562-3354
(608) 354-7093
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11028
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11028
PHARMACIST
WI
01
—
1189627
NABP
—
Enumeration date
09/19/2018
Last updated
09/19/2018
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