Healthcare Provider Details

I. General information

NPI: 1174218267
Provider Name (Legal Business Name): STEVEN ZAKRAJSEK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/06/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 W BROADWAY AVE
MINNEAPOLIS MN
55411-1735
US

IV. Provider business mailing address

2806 BRANCH ST
DULUTH MN
55812-2337
US

V. Phone/Fax

Practice location:
  • Phone: 612-302-8200
  • Fax:
Mailing address:
  • Phone: 218-260-6295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number813845
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: