Provider Demographics
NPI:1881664464
Name:MOHLER, JOHN MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:MOHLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1113 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1141
Mailing Address - Country:US
Mailing Address - Phone:313-277-6485
Mailing Address - Fax:586-276-8039
Practice Address - Street 1:31700 VAN DYKE AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-7940
Practice Address - Country:US
Practice Address - Phone:586-276-8035
Practice Address - Fax:586-276-8039
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist