Provider Demographics
NPI:1427345040
Name:OVERMAN, MICHEL ANDREW (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHEL
Middle Name:ANDREW
Last Name:OVERMAN
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 1:3116 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4204
Mailing Address - Country:US
Mailing Address - Phone:252-830-1445
Mailing Address - Fax:252-830-0393
Practice Address - Street 1:3116 E 10TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4204
Practice Address - Country:US
Practice Address - Phone:252-830-1445
Practice Address - Fax:252-830-0393
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-04
Last Update Date:2011-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist