Provider Demographics
NPI:1447414818
Name:AHLERS, MICHAEL DAVID (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DAVID
Last Name:AHLERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:56187-2703
Mailing Address - Country:US
Mailing Address - Phone:507-372-7371
Mailing Address - Fax:507-372-7781
Practice Address - Street 1:923 6TH AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2703
Practice Address - Country:US
Practice Address - Phone:507-372-7371
Practice Address - Fax:507-372-7781
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist