Healthcare Provider Details

I. General information

NPI: 1689751406
Provider Name (Legal Business Name): DAVID R PALAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E GRAND RIVER AVE
FOWLERVILLE MI
48836-5109
US

IV. Provider business mailing address

5638 CEDAR RIDGE DR
ANN ARBOR MI
48103-9097
US

V. Phone/Fax

Practice location:
  • Phone: 517-223-9832
  • Fax: 517-223-7267
Mailing address:
  • Phone: 734-663-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5302034356
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20248
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302034356
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: