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NPI Code Detail

MEDICARE: MRS. KAREN LEDUC R. PH.

MEDICARE: MRS. KAREN LEDUC R. PH.
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
11835P1200XPharmacotherapy Pharmacist5302411015MI

General Provider Information

NPI Number : 1215347877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN LEDUC R. PH.
Provider Business Mailing Address
First Line : 49111 BROCKTON CT
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48047-1747
Country : US
Telephone Number : 586-566-4133
Fax Number : 586-566-4165
Provider Business Practice Location Address
First Line : 15055 HALL RD
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-6206
Country : US
Telephone Number : 586-566-4133
Fax Number : 586-566-4165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2014
Last Update Date : 05/05/2014

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