Provider Demographics
NPI:1205974565
Name:MATSCHIKOWSKI, STEVEN JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:MATSCHIKOWSKI
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 1:1654 HAROLD LN
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-9042
Mailing Address - Country:US
Mailing Address - Phone:810-632-7377
Mailing Address - Fax:
Practice Address - Street 1:1654 HAROLD LN
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-9042
Practice Address - Country:US
Practice Address - Phone:810-632-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI410863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist