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General NPI Number Information
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NPI Number | 1750795340
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Entity Type | Individual
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Provider Name | DUSTIN HUSS PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 419 W MAIN ST
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City | GAYLORD
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State | MI
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Zip | 49735-1859
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Country | US
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Telephone | 989-732-5220
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Fax |
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Provider Business Mailing Address
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Address Line | 20499 20 MILE RD
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City | TUSTIN
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State | MI
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Zip | 49688-8020
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Country | US
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Telephone | 231-829-5088
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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 | 5302039315
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License Number State | MI
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