Provider Demographics
NPI:1548540180
Name:KLUESNER, MARTIN CHARLES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CHARLES
Last Name:KLUESNER
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 1:2260 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2881
Mailing Address - Country:US
Mailing Address - Phone:563-582-1659
Mailing Address - Fax:563-582-1863
Practice Address - Street 1:2260 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-2881
Practice Address - Country:US
Practice Address - Phone:563-582-1659
Practice Address - Fax:563-582-1863
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist