MEDICARE: DR. DEBRA WUNDER PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13682-040	WI

General Provider Information

NPI Number	:	1538566310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA WUNDER PHARM. D.

Provider Business Mailing Address
First Line	:	1008 MILWAUKEE AVE
Second Line	:
City	:	BURLINGTON
State	:	WI
Zip	:	53105-1362
Country	:	US
Telephone Number	:	262-767-1446
Fax Number	:	262-767-1889

Provider Business Practice Location Address
First Line	:	1008 MILWAUKEE AVE
Second Line	:
City	:	BURLINGTON
State	:	WI
Zip	:	53105-1362
Country	:	US
Telephone Number	:	262-767-1446
Fax Number	:	262-767-1889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2014
Last Update Date	:	11/22/2014

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