Provider Demographics
NPI:1982826392
Name:MCDIARMID, DAVID JAMES JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:MCDIARMID
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1900 WEALTHY ST SE
Mailing Address - Street 2:STE 105
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2969
Mailing Address - Country:US
Mailing Address - Phone:616-774-7799
Mailing Address - Fax:616-459-7930
Practice Address - Street 1:1900 WEALTHY ST SE
Practice Address - Street 2:SUITE 105
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2969
Practice Address - Country:US
Practice Address - Phone:616-774-7799
Practice Address - Fax:616-459-7930
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302028948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302028948OtherPHARMACIST LICENSE