Provider Demographics
NPI:1154302248
Name:STRUCKMAN, DANIEL ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:STRUCKMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:ROBERT
Other - Last Name:STRUCKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:215 BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-5934
Mailing Address - Country:US
Mailing Address - Phone:406-256-3588
Mailing Address - Fax:
Practice Address - Street 1:215 BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5934
Practice Address - Country:US
Practice Address - Phone:406-256-3588
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3024183500000X
MTBCPS 2982341835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy