Individual
DR. MICHAEL THOMAS LUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1750 E BROADWAY RD, TEMPE, AZ 85282-1612
(480) 557-0970
Mailing address
1750 E BROADWAY RD, TEMPE, AZ 85282-1612
(480) 557-0970
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019897
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S019897
PHARMACIST LICENSE
AZ
Enumeration date
04/09/2014
Last updated
04/09/2014
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