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Search › Michigan › 1835P1200X

Justin Super, PHARM.D

NPI 1295283778 · on the registry since 2016 · sole proprietor

Practice

Address
21431 Grand River Ave
Detroit, MI 48219
Phone
(313) 778-7610
Fax
(313) 778-7665
Organisation at this address
Meijer, Inc.
Children'S Ambulatory Services, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
1835P1200X
1835P1200X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-09-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan