Provider Demographics
NPI:1548507478
Name:SOWPEL, GARY STEVENS (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:STEVENS
Last Name:SOWPEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 HOGAN WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-6302
Mailing Address - Country:US
Mailing Address - Phone:734-377-2111
Mailing Address - Fax:
Practice Address - Street 1:2736 HOGAN WAY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-6302
Practice Address - Country:US
Practice Address - Phone:734-377-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist