Steven Lloyd Bladow, PHARMD

Individual provider Active NPI Pharmacist · Shakopee, MN

NPI 1295042620 · NPPES record last updated Sep 7, 2010

Key facts

NPI
1295042620
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
119838 (MN)
Practice address
7467 Hampton LN
Shakopee, MN 55379-7025
Phone
(612) 234-5552
Fax
(763) 416-2769
NPI assigned
Sep 7, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
119838MNMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 119838 MN Yes

Addresses

Primary practice location

7467 Hampton LN
Shakopee, MN 55379-7025

Mailing address

7467 Hampton LN
Shakopee, MN 55379-7025
Phone (612) 234-5552

Other providers in Shakopee, MN

All providers in Shakopee, MN · Pharmacist in Minnesota

Sources for this page

Verify at the official NPI Registry.