Provider Demographics
NPI:1295042620
Name:BLADOW, STEVEN LLOYD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LLOYD
Last Name:BLADOW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7467 HAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-7025
Mailing Address - Country:US
Mailing Address - Phone:612-234-5552
Mailing Address - Fax:763-416-2769
Practice Address - Street 1:7467 HAMPTON LN
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-7025
Practice Address - Country:US
Practice Address - Phone:612-234-5552
Practice Address - Fax:763-416-2769
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist