Provider Demographics
NPI:1386369585
Name:ITSCHNER II, MICHAEL S II (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:ITSCHNER II
Suffix:II
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 1:3924 PARKMEAD DR APT 309
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-4029
Mailing Address - Country:US
Mailing Address - Phone:740-504-3622
Mailing Address - Fax:
Practice Address - Street 1:1795 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1765
Practice Address - Country:US
Practice Address - Phone:740-335-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy