Individual
MARCUS MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
795 W OVERLAND RD, MERIDIAN, ID 83642-6556
(208) 917-6905
Mailing address
795 W OVERLAND RD, MERIDIAN, ID 83642-6556
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8435
ID
183500000X
Pharmacist
RPH-0017434
OR
Other
Enumeration date
11/16/2019
Last updated
11/16/2019
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