MEDICARE: MR. RONALD PAWLAK RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302023624	MI

General Provider Information

NPI Number	:	1013353507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD PAWLAK RPH

Provider Business Mailing Address
First Line	:	34379 FONTANA DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-5775
Country	:	US
Telephone Number	:	586-264-0391
Fax Number	:

Provider Business Practice Location Address
First Line	:	20352 HARPER AVE
Second Line	:
City	:	HARPER WOODS
State	:	MI
Zip	:	48225-1643
Country	:	US
Telephone Number	:	313-884-5400
Fax Number	:	313-884-0011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2013
Last Update Date	:	05/11/2013

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