Provider Demographics
NPI:1538276977
Name:KUS, DANIEL PAUL (RPH)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:KUS
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 1:32965 BROOKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1426
Mailing Address - Country:US
Mailing Address - Phone:734-751-8004
Mailing Address - Fax:248-258-2395
Practice Address - Street 1:30100 TELEGRAPH RD
Practice Address - Street 2:SUITE #200
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4514
Practice Address - Country:US
Practice Address - Phone:248-723-0255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI024226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA024226OtherMICHIGAN LICENSE