Provider Demographics
NPI:1477875516
Name:ZDUN, DAVID M (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:ZDUN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1608
Mailing Address - Country:US
Mailing Address - Phone:610-876-1953
Mailing Address - Fax:
Practice Address - Street 1:2546 METROPOLITAN DR
Practice Address - Street 2:
Practice Address - City:TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6738
Practice Address - Country:US
Practice Address - Phone:215-639-6162
Practice Address - Fax:215-639-6209
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002490183500000X
PARP039281L183500000X
NJ28RI02704600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist