Individual
DR. TODD SUPER
Active
Individual
DR. TODD SUPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D., BCPS
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302036387
MI
1835P1200X
Pharmacotherapy Pharmacist
5302036387
MI
1835P2201X
Ambulatory Care Pharmacist
Primary
5302036387
MI
Other
Enumeration date
07/31/2014
Last updated
07/10/2018
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