Provider Demographics
NPI:1578298261
Name:COURTEAU, DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:COURTEAU
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 1:3415 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1135
Mailing Address - Country:US
Mailing Address - Phone:216-651-0212
Mailing Address - Fax:
Practice Address - Street 1:7590 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9176
Practice Address - Country:US
Practice Address - Phone:440-354-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2024-03-16
Deactivation Date:2022-11-20
Deactivation Code:
Reactivation Date:2022-11-29
Provider Licenses
StateLicense IDTaxonomies
OH03442512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist