Provider Demographics
NPI:1740815042
Name:JOZEFCZYK, SHAWN MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:JOZEFCZYK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 W RAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8806
Mailing Address - Country:US
Mailing Address - Phone:414-423-5257
Mailing Address - Fax:
Practice Address - Street 1:5220 W RAWSON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8806
Practice Address - Country:US
Practice Address - Phone:414-423-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20159-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist