Provider Demographics
NPI:1801968227
Name:MCDONALD, STEVEN THOMAS (PHARMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:THOMAS
Last Name:MCDONALD
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 1:8409 W ASHFORD LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-9005
Mailing Address - Country:US
Mailing Address - Phone:765-759-5665
Mailing Address - Fax:
Practice Address - Street 1:409 E GREENVILLE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WINCHESTER
Practice Address - State:IN
Practice Address - Zip Code:47394-9436
Practice Address - Country:US
Practice Address - Phone:765-584-5410
Practice Address - Fax:765-584-5436
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020886A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist