Provider Demographics
NPI:1003027665
Name:MESSERLY, RICHARD C (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:C
Last Name:MESSERLY
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 1:2345 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1840
Mailing Address - Country:US
Mailing Address - Phone:248-334-5076
Mailing Address - Fax:
Practice Address - Street 1:2345 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-1840
Practice Address - Country:US
Practice Address - Phone:248-334-5076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-09074183500000X
MI5302026084183500000X
AZ9578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist