Provider Demographics
NPI:1356332209
Name:KAISER, DAVID W (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:W
Last Name:KAISER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6090 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6154
Mailing Address - Country:US
Mailing Address - Phone:231-777-8402
Mailing Address - Fax:231-777-8443
Practice Address - Street 1:1700 OAK AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-2407
Practice Address - Country:US
Practice Address - Phone:231-777-8402
Practice Address - Fax:231-777-8443
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302030373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist