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General NPI Number Information
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NPI Number | 1700036555
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Entity Type | Individual
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Provider Name | DUSTIN PATRICK EHSTER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 5000 W NATIONAL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53295-0001
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Country | US
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Telephone | 414-384-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 N VAN BUREN ST APT 506
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City | MILWAUKEE
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State | WI
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Zip | 53202-2665
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Country | US
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Telephone | 414-460-0433
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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 | 11420-040
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License Number State | WI
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