IndividualActive
Michael Bolan
NPI 1609379726 · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fort Wainwright, AK
Provider details
- NPI number
- 1609379726
- Entity type
- Individual
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 03236558 (OH)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
4076 Neely Road
Fort Wainwright, AK 99709
Phone: (907) 361-5109
Approximate (ZIP-level) locationGet directions
Mailing address
3010 Davis Rd Apt B3
Fairbanks, AK 99709-5236
Registry dates
- Enumerated
- 2018-03-15
- Last updated
- 2018-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.