Individual
DR. ALAN RUSSELL MCDILDA II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
425 CAMDEN RD, HUNTINGTON, WV 25704-2708
(304) 429-5544
Mailing address
425 CAMDEN RD, HUNTINGTON, WV 25704-2708
(304) 429-5544
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
015864
KY
183500000X
Pharmacist
03129921
OH
183500000X
Pharmacist
Primary
RP0007171
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015864
KENTUCKY BOARD OF PHARMACY
KY
01
—
03129921
OHIO BOARD OF PHARMACY
OH
01
—
RP0007171
WEST VIRGINIA BOARD OF PHARMACY
WV
Enumeration date
04/20/2018
Last updated
04/20/2018
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