Provider Demographics
NPI:1780923383
Name:DUDA, KARL ANTHONY (RPH)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:ANTHONY
Last Name:DUDA
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 1:310 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-8614
Mailing Address - Country:US
Mailing Address - Phone:517-279-8785
Mailing Address - Fax:
Practice Address - Street 1:500 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2042
Practice Address - Country:US
Practice Address - Phone:517-278-8272
Practice Address - Fax:517-278-8352
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist