Kwanjoon Cha, PHARM.D
Individual provider Active NPI Pharmacist · Comstock Park, MI
NPI 1700201142 · NPPES record last updated Feb 21, 2014
Key facts
- NPI
- 1700201142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302038991 (MI)
- Practice address
- 3802 Yorkland Dr NW Apt 1
Comstock Park, MI 49321-8894 - Phone
- (214) 772-4917
- NPI assigned
- Feb 21, 2014
- Sex
- Male
- Sole proprietor
- No
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038991 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302038991 | MI | Yes |
Addresses
Primary practice location
3802 Yorkland Dr NW Apt 1
Comstock Park, MI 49321-8894
Mailing address
3802 Yorkland Dr NW Apt 1
Comstock Park, MI 49321-8894
Phone (214) 772-4917
Other providers in Comstock Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.