Active NPI
Patrick Gonczar
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Croswell, MI
National Provider Identifier
1790210326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 5302029185
- Practice address
- 57 N Howard Ave
Croswell, MI 48422-1222 - Phone
- (810) 679-3900
- Fax
- (810) 679-4154
- NPI assigned
- Apr 20, 2017
- Last updated
- Apr 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302029185 | MI | Primary |
Addresses
Primary practice location
57 N Howard Ave
Croswell, MI 48422-1222
Mailing address
57 N Howard Ave
Croswell, MI 48422-1222
Phone (810) 679-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302029185 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1790210326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 N HOWARD AVE",
"city": "CROSWELL",
"state": "MI",
"postal_code": "484221222",
"telephone_number": "810-679-3900",
"fax_number": "810-679-4154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 N HOWARD AVE",
"city": "CROSWELL",
"state": "MI",
"postal_code": "484221222",
"telephone_number": "810-679-3900",
"fax_number": "810-679-4154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONCZAR",
"first_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-20",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MI",
"license": "5302029185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Croswell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.