Provider Demographics
NPI:1053721928
Name:SZYMANSKI, MICHAEL JUDE (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JUDE
Last Name:SZYMANSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22251 HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:CURTICE
Mailing Address - State:OH
Mailing Address - Zip Code:43412-9697
Mailing Address - Country:US
Mailing Address - Phone:419-836-9114
Mailing Address - Fax:419-836-9114
Practice Address - Street 1:1725 S WHEELING ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3962
Practice Address - Country:US
Practice Address - Phone:419-697-2033
Practice Address - Fax:419-697-2065
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032196931835P1200X
MI53020287761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy