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Individual

GEORGE STEHPEN DIDUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
5751 CLARKSTON RD, CLARKSTON, MI 48348
(248) 625-1015
Mailing address
3820 S HADLEY RD, ORTONVILLE, MI 48462-9115
(248) 627-3116

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025263
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302025263
REGISTERED PHARMACIST LIC
MI
Enumeration date
12/29/2006
Last updated
07/08/2007
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