Provider Demographics
NPI:1669763124
Name:MEYER-PRETORIUS, MARGARET CORNELIA
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:CORNELIA
Last Name:MEYER-PRETORIUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19205 HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-5413
Mailing Address - Country:US
Mailing Address - Phone:707-938-0547
Mailing Address - Fax:
Practice Address - Street 1:19205 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-5413
Practice Address - Country:US
Practice Address - Phone:707-938-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist