MEDICARE: KANWALJIT KAUR

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	5302036893	MI

General Provider Information

NPI Number	:	1750780433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANWALJIT KAUR

Provider Business Mailing Address
First Line	:	4238 DICKSON DR
Second Line	:
City	:	STERLING HTS
State	:	MI
Zip	:	48310-4540
Country	:	US
Telephone Number	:	586-873-5579
Fax Number	:

Provider Business Practice Location Address
First Line	:	28350 S RIVER RD
Second Line	:
City	:	HARRISON TOWNSHIP
State	:	MI
Zip	:	48045-3011
Country	:	US
Telephone Number	:	586-463-8661
Fax Number	:

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

Provider Enumeration Date	:	08/18/2014
Last Update Date	:	08/18/2014

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Directions to “ KANWALJIT KAUR ” Practice Location

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