Provider Demographics
NPI:1043818701
Name:DRAPER, MICHAEL H (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:DRAPER
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:E13502 COUNTY ROAD AF
Mailing Address - Street 2:
Mailing Address - City:FALL CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:54742-4028
Mailing Address - Country:US
Mailing Address - Phone:218-290-2867
Mailing Address - Fax:
Practice Address - Street 1:3915 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-8165
Practice Address - Country:US
Practice Address - Phone:715-834-5966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist