Provider Demographics
NPI:1841560281
Name:RUTKOWSKI, JAMES M (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:RUTKOWSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 EXETER DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3233
Mailing Address - Country:US
Mailing Address - Phone:248-684-9454
Mailing Address - Fax:
Practice Address - Street 1:13700 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2215
Practice Address - Country:US
Practice Address - Phone:734-427-2866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist