Provider Demographics
NPI:1700901352
Name:GERWIG, MICHELLE ANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANN
Last Name:GERWIG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:D'ANGELO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:915 GEORGIAN DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1471
Mailing Address - Country:US
Mailing Address - Phone:585-226-6275
Mailing Address - Fax:
Practice Address - Street 1:400 FORT HILL AVE
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1159
Practice Address - Country:US
Practice Address - Phone:585-394-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist