Healthcare Provider Details

I. General information

NPI: 1083743330
Provider Name (Legal Business Name): STEVEN ROBERT JENSEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7067 DEXTER ANN ARBOR RD
DEXTER MI
48130-8568
US

IV. Provider business mailing address

3604 NOBLE DR
DEXTER MI
48130-9202
US

V. Phone/Fax

Practice location:
  • Phone: 734-426-6210
  • Fax:
Mailing address:
  • Phone: 734-971-1013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302032703
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: