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Individual

DR. BENJAMIN DAVID KLUGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD, MBA

Contact information

Practice address
11111 W BURLEIGH RD, WAUWATOSA, WI 53222
(414) 290-0910
Mailing address
11111 W BURLEIGH ST, WAUWATOSA, WI 53222-3211
(414) 290-0910

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18692-40
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18692-40
PHARMACIST LICENSE
WI
Enumeration date
12/13/2016
Last updated
12/13/2016
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