Provider Demographics
NPI:1306938303
Name:ALAN, DAVID WOJDULA (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WOJDULA
Last Name:ALAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 E CEDAR PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-3566
Mailing Address - Country:US
Mailing Address - Phone:708-351-8920
Mailing Address - Fax:
Practice Address - Street 1:2760 E CEDAR PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-3566
Practice Address - Country:US
Practice Address - Phone:708-351-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410949183500000X
IL51040212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist