Provider Demographics
NPI:1003679515
Name:SALZWEDEL, CHRISTINE EUNJUNG (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:EUNJUNG
Last Name:SALZWEDEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4078 WYNDAM HILL DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6481
Mailing Address - Country:US
Mailing Address - Phone:224-805-9703
Mailing Address - Fax:
Practice Address - Street 1:3350 STEVE REYNOLD BLVD STE 406
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:678-434-0009
Practice Address - Fax:678-434-0070
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028324183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist