Provider Demographics
NPI:1548537343
Name:SZEMRAJ, PAUL (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SZEMRAJ
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:N100W14591 SUNBURST TRL
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-5396
Mailing Address - Country:US
Mailing Address - Phone:414-467-9215
Mailing Address - Fax:
Practice Address - Street 1:1921 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-5206
Practice Address - Country:US
Practice Address - Phone:262-338-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist