Provider Demographics
NPI:1649415514
Name:ERMAN, JEFFREY DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:ERMAN
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 1:3909 BEECHER RD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3602
Mailing Address - Country:US
Mailing Address - Phone:810-762-1145
Mailing Address - Fax:810-762-4260
Practice Address - Street 1:3909 BEECHER RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3602
Practice Address - Country:US
Practice Address - Phone:810-762-1145
Practice Address - Fax:810-762-4260
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist