Healthcare Provider Details

I. General information

NPI: 1184706137
Provider Name (Legal Business Name): PAUL G KUZNER RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16828 21 MILE RD
MACOMB MI
48044-2601
US

IV. Provider business mailing address

52757 FLORENCE DR
SHELBY TOWNSHIP MI
48315-2078
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-9100
  • Fax: 586-263-4455
Mailing address:
  • Phone: 586-739-3004
  • Fax: 586-263-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302411137
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: