Provider Demographics
NPI:1437752607
Name:SZATKOWSKI, PAUL (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SZATKOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2R 295 FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-2790
Mailing Address - Country:US
Mailing Address - Phone:207-885-2011
Mailing Address - Fax:207-885-3043
Practice Address - Street 1:2R 295 FOREST AVENUE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2790
Practice Address - Country:US
Practice Address - Phone:207-885-2011
Practice Address - Fax:207-885-3043
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist