Provider Demographics
NPI:1144658642
Name:KUJAT, PATRICK ROBERT (PHARM D)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:ROBERT
Last Name:KUJAT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2741
Mailing Address - Country:US
Mailing Address - Phone:248-685-7219
Mailing Address - Fax:
Practice Address - Street 1:140 S MILFORD RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2741
Practice Address - Country:US
Practice Address - Phone:248-685-7219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist