Provider Demographics
NPI:1386753879
Name:MESSER, STEPHEN LEE (RPH)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:LEE
Last Name:MESSER
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 1:5520 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-2190
Mailing Address - Country:US
Mailing Address - Phone:515-263-1572
Mailing Address - Fax:
Practice Address - Street 1:5520 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-2190
Practice Address - Country:US
Practice Address - Phone:515-263-1572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist