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General NPI Number Information
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NPI Number | 1851929194
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Entity Type | Individual
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Provider Name | MICHAEL P WUNDER RPH
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 1226 N 52ND ST
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City | PHILADELPHIA
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State | PA
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Zip | 19131-4315
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Country | US
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Telephone | 215-377-9531
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Fax | 215-377-9530
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Provider Business Mailing Address
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Address Line | 1 TEAL DR
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City | LANGHORNE
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State | PA
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Zip | 19047-8233
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Country | US
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Telephone | 215-680-2491
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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 | RP030330L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI01725200
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License Number State | NJ
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