Individual
MR. CHARLES M CANVASSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
34500 FORD RD, WESTLAND, MI 48185-3090
(734) 729-2200
(734) 729-3857
Mailing address
7343 VILLAGE SQUARE DR, WEST BLOOMFIELD, MI 48322-3384
(248) 788-0298
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302024145
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2940800
—
MI
Enumeration date
10/10/2006
Last updated
07/08/2007
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