Individual
MICHAELA ROSE CLAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(734) 649-1357
Mailing address
6014 SYCAMORE FORGE LN, INDIANAPOLIS, IN 46254-1293
(734) 649-1357
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26030416A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39557
TEXAS STATE BOARD OF PHARMACY STUDENT TRAINEE
TX
Enumeration date
01/28/2020
Last updated
02/12/2024
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