Carmen Bakdaleyeh, PHARMD
Individual provider Active NPI Pharmacist · Clio, MI
NPI 1700348117 · NPPES record last updated Apr 3, 2019
Key facts
- NPI
- 1700348117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302042836 (MI)
- Practice address
- 11493 N Linden Rd
Clio, MI 48420-8586 - Phone
- (810) 564-4278
- NPI assigned
- Apr 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302042836 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302042836 | MI | Yes |
Addresses
Primary practice location
11493 N Linden Rd
Clio, MI 48420-8586
Mailing address
6932 Cooley Lake Rd
White Lake, MI 48383-3406
Phone (248) 767-2416
Other providers in Clio, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.