Provider Demographics
NPI:1609199546
Name:MICHALSKI, ANTHONY PETER
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PETER
Last Name:MICHALSKI
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 1:635 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4918
Mailing Address - Country:US
Mailing Address - Phone:920-437-0206
Mailing Address - Fax:920-437-0276
Practice Address - Street 1:635 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4918
Practice Address - Country:US
Practice Address - Phone:209-437-0206
Practice Address - Fax:920-437-0276
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033992183500000X
WI14771-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist