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General NPI Number Information
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NPI Number | 1457468910
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Entity Type | Individual
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Provider Name | MICHAEL RICHARD DRAEGER R PH
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9051 W HEATHER AVE
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City | MILWAUKEE
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State | WI
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Zip | 53224
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Country | US
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Telephone | 414-410-8106
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Fax | 914-410-8181
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Provider Business Mailing Address
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Address Line | 2031 ERIE STREET
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City | GRAFTON
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State | WI
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Zip | 53024
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Country | US
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Telephone | 262-377-5796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 8412040
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License Number State | WI
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