Donovan Matthew Haddix, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302032555 Issued in MI

Practice address

29255 W Jefferson Ave
Gibraltar, MI 48173-9738

Phone

(734) 675-0000

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316022502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23111 LORRAINE BLVD",
            "address_2": "APT 102",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481833096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29255 W JEFFERSON AVE",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "481739738",
            "telephone_number": "734-675-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDIX",
        "first_name": "DONOVAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Cain
• City of Gibraltar (Gibraltar PSD)
• Conscious Mind Psychiatry of Michigan (Conscious Mind Psychiatry)
• Tim Charles Desano
• Gibraltar Pharmacy Inc (Gibraltar Sav-Mor Pharmacy #16)
• Warren Michael Horbal, D.D.S.
• Jennifer Lyn Johnson, MS LLP
• Elizabeth Sarah Jordan
• Nida Kased
• Stephanie Lauren Marl, PMHNP-BC

• Pharmacist in Gibraltar, MI
• Providers in Gibraltar, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.