Provider Demographics
NPI:1235331653
Name:WILPULA, DAVID (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:WILPULA
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30254 WESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2347
Mailing Address - Country:US
Mailing Address - Phone:248-539-0524
Mailing Address - Fax:313-593-8823
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-996-7293
Practice Address - Fax:313-593-8823
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020347211835P1200X
PARP4378471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy