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NPI 1881664464

NPI 1881664464 : JOHN MICHAEL MOHLER RPH : WARREN, MI

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General NPI Number Information
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    NPI Number           |    1881664464
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN MICHAEL MOHLER RPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/25/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    31700 VAN DYKE AVE SUITE 190
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    City                 |    WARREN
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    State                |    MI
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    Zip                  |    48093-7940
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    Country              |    US
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    Telephone            |    586-276-8035
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    Fax                  |    586-276-8039
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Provider Business Mailing Address
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    Address Line         |    1113 N LAFAYETTE ST 
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    City                 |    DEARBORN
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    State                |    MI
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    Zip                  |    48128-1141
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    Country              |    US
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    Telephone            |    313-277-6485
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    Fax                  |    586-276-8039
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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       |    5302028290
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    License Number State |    MI
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