Provider Demographics
NPI:1689694549
Name:SCHLOTT, MARK E (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:SCHLOTT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:3951 BLUE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-9259
Mailing Address - Country:US
Mailing Address - Phone:517-322-8200
Mailing Address - Fax:517-322-8242
Practice Address - Street 1:1401 S CREYTS RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8507
Practice Address - Country:US
Practice Address - Phone:517-322-8200
Practice Address - Fax:517-322-8242
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302023747183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist