Provider Demographics
NPI:1194384917
Name:OVERTOOM, MICHELE DAWSON (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:DAWSON
Last Name:OVERTOOM
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19535 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MD
Mailing Address - Zip Code:21053-9406
Mailing Address - Country:US
Mailing Address - Phone:410-375-4827
Mailing Address - Fax:443-491-3854
Practice Address - Street 1:WEGMANS PHARMACY #125
Practice Address - Street 2:10100 REISTERSTOWN ROAD
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:443-491-2345
Practice Address - Fax:443-491-2398
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD11746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist