Provider Demographics
NPI:1417625997
Name:BERMUDEZ, DAVID ALEJANDO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALEJANDO
Last Name:BERMUDEZ
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 1:8639 GLENGARY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1282
Mailing Address - Country:US
Mailing Address - Phone:131-328-7807
Mailing Address - Fax:
Practice Address - Street 1:16300 FORT ST
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1421
Practice Address - Country:US
Practice Address - Phone:734-284-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53024137491835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy