Provider Demographics
NPI:1730994328
Name:PERCZAK, RYAN ALEXANDER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ALEXANDER
Last Name:PERCZAK
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 1:5104 COOPERS LANDING DR APT 3D
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49004-7702
Mailing Address - Country:US
Mailing Address - Phone:248-946-1364
Mailing Address - Fax:
Practice Address - Street 1:6020 B DR N
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-8367
Practice Address - Country:US
Practice Address - Phone:269-979-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-10-18
Deactivation Date:2025-09-03
Deactivation Code:
Reactivation Date:2025-10-01
Provider Licenses
StateLicense IDTaxonomies
MI5302418014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist