Provider Demographics
NPI:1346618600
Name:KALSI, RAJPAL
Entity Type:Individual
Prefix:
First Name:RAJPAL
Middle Name:
Last Name:KALSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-9606
Mailing Address - Country:US
Mailing Address - Phone:810-724-7692
Mailing Address - Fax:810-724-6064
Practice Address - Street 1:2070 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-9606
Practice Address - Country:US
Practice Address - Phone:810-724-7692
Practice Address - Fax:810-724-6064
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030525183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist