Individual
DR. MATTHEW RUSSELL DIERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
600 HIGHLAND AVE, F6/133-1530, MADISON, WI 53792-0001
(608) 263-1284
Mailing address
600 HIGHLAND AVE, F6/133-1530, MADISON, WI 53792-0001
(608) 263-1284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14941-040
WI
183500000X
Pharmacist
26022406A
IN
Other
Enumeration date
09/06/2007
Last updated
01/27/2008
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