Provider Demographics
NPI:1841390697
Name:ROCKAFELLOW, STUART D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:D
Last Name:ROCKAFELLOW
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 1:716 HUTCHINS AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4802
Mailing Address - Country:US
Mailing Address - Phone:734-761-7081
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DRIVE SE
Practice Address - Street 2:NEW MEXICO VA HEALTHCARE SYSTEM
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5154
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist