Provider Demographics
NPI:1417367830
Name:DRUZINSKI, GERALD
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:DRUZINSKI
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 1:3610 MARKETPLACE CIR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-5515
Mailing Address - Country:US
Mailing Address - Phone:248-844-2864
Mailing Address - Fax:248-844-2865
Practice Address - Street 1:3610 MARKETPLACE CIR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-5515
Practice Address - Country:US
Practice Address - Phone:248-844-2864
Practice Address - Fax:248-844-2865
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020238691835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy