Provider Demographics
NPI:1154581734
Name:MEHALL, JOSEPH ANDREW (PHARMD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:MEHALL
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 1:29808 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1959
Mailing Address - Country:US
Mailing Address - Phone:734-301-3011
Mailing Address - Fax:
Practice Address - Street 1:22315 MOROSS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2116
Practice Address - Country:US
Practice Address - Phone:313-885-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist