Provider Demographics
NPI:1013353507
Name:PAWLAK, RONALD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:PAWLAK
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 1:34379 FONTANA DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-5775
Mailing Address - Country:US
Mailing Address - Phone:586-264-0391
Mailing Address - Fax:
Practice Address - Street 1:20352 HARPER AVE
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1643
Practice Address - Country:US
Practice Address - Phone:313-884-5400
Practice Address - Fax:313-884-0011
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-11
Last Update Date:2013-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist