Provider Demographics
NPI:1154430361
Name:DONOVAN, MICHAEL JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:DONOVAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 MEGOWN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9061
Mailing Address - Country:US
Mailing Address - Phone:724-348-8102
Mailing Address - Fax:
Practice Address - Street 1:600 OLD CLAIRTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4313
Practice Address - Country:US
Practice Address - Phone:412-655-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033530L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist