Healthcare Provider Details

I. General information

NPI: 1093258709
Provider Name (Legal Business Name): DAVID ROBERT STEPANIK R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9885 ROCKSIDE RD STE 157
CLEVELAND OH
44125-6272
US

IV. Provider business mailing address

9885 ROCKSIDE RD STE 157
CLEVELAND OH
44125-6272
US

V. Phone/Fax

Practice location:
  • Phone: 216-957-6337
  • Fax: 216-957-4760
Mailing address:
  • Phone: 216-957-6337
  • Fax: 216-957-4760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03214037
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: