Provider Demographics
NPI:1104260140
Name:DOAN, ALLEN RAYMOND (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:RAYMOND
Last Name:DOAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2296 US 41 S
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9119
Mailing Address - Country:US
Mailing Address - Phone:906-273-1306
Mailing Address - Fax:906-273-1307
Practice Address - Street 1:2296 US 41 S
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9119
Practice Address - Country:US
Practice Address - Phone:906-273-1306
Practice Address - Fax:906-273-1307
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020332481835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear