Individual
MARK PHILIP MICHALOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
653 BROADWAY, BANGOR, ME 04401-3341
(207) 947-3680
(207) 947-5671
Mailing address
790 FULLER RD, HERMON, ME 04401-0107
(207) 991-2348
(207) 947-5671
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR4706
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447368824
HANNAFORD
ME
Enumeration date
11/11/2020
Last updated
11/11/2020
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