Provider Demographics
NPI:1841939691
Name:SCHILDKNECHT, DYLAN LEWIS (PHARMD)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:LEWIS
Last Name:SCHILDKNECHT
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 1:8224 BELLA VISTA BLVD APT 4201
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-3127
Mailing Address - Country:US
Mailing Address - Phone:317-607-1268
Mailing Address - Fax:
Practice Address - Street 1:1424 S RANGELINE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2934
Practice Address - Country:US
Practice Address - Phone:317-571-1176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCV2201292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist