Charles Wickersham, PHARMD.

NPI #1063772846 in Modesto, California

Provider Information

NPI Number: 1063772846
Entity Type: Individual
Name: Charles Wickersham, PHARMD.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARMD.
Enumeration Date: May 25, 2012
Last Updated: May 25, 2012

Practice Location

Address: 2020 COFFEE RD
Address 2: SUITE C2
City: Modesto
State: California
ZIP Code: 95355-2427
Phone: (209) 522-3367

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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