Provider Demographics
NPI:1194320564
Name:DONOHUE, MICHAEL S (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:DONOHUE
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 1:1519 W OSBORN RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-5954
Mailing Address - Country:US
Mailing Address - Phone:602-799-5834
Mailing Address - Fax:866-549-7809
Practice Address - Street 1:1519 W OSBORN RD APT 2
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5954
Practice Address - Country:US
Practice Address - Phone:602-799-5834
Practice Address - Fax:866-549-7809
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0083201835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty