Provider Demographics
NPI:1689849317
Name:GIRDWOOD, CARLA ANDREEA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ANDREEA
Last Name:GIRDWOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-9104
Mailing Address - Country:US
Mailing Address - Phone:586-596-4023
Mailing Address - Fax:
Practice Address - Street 1:100 COVERED VLG
Practice Address - Street 2:
Practice Address - City:BELDING
Practice Address - State:MI
Practice Address - Zip Code:48809-1683
Practice Address - Country:US
Practice Address - Phone:616-794-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist