Healthcare Provider Details

I. General information

NPI: 1255977336
Provider Name (Legal Business Name): MRS. DANIEL SZELONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2019
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7084 MILLER RD
SWARTZ CREEK MI
48473-1527
US

IV. Provider business mailing address

7084 MILLER RD
SWARTZ CREEK MI
48473-1527
US

V. Phone/Fax

Practice location:
  • Phone: 810-630-0585
  • Fax: 810-630-1535
Mailing address:
  • Phone: 810-630-0585
  • Fax: 810-630-1535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302025764
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: