Provider Demographics
NPI:1689038705
Name:BERMOY, WILLIAM ANTHONY III
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:BERMOY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
Mailing Address - Street 2:MADIGAN ARMY MEDICAL CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-1110
Mailing Address - Fax:877-874-1031
Practice Address - Street 1:9040 JACKSON AVE, ATTN: MCHJ-CLQ-C
Practice Address - Street 2:MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-1110
Practice Address - Fax:877-874-1031
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
E2070268146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic