Brooke Meade Bonham, PHARM D
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Gibraltar, MI
NPI 1831535665 · NPPES record last updated Mar 11, 2021
Key facts
- NPI
- 1831535665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 5302031257 (MI)
- Practice address
- 29255 W Jefferson Ave
Gibraltar, MI 48173-9738 - Phone
- (734) 675-0000
- NPI assigned
- May 20, 2013
- 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 |
|---|---|---|---|
| 5302031257 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302031257 | MI | Yes |
Addresses
Primary practice location
29255 W Jefferson Ave
Gibraltar, MI 48173-9738
Mailing address
8900 Macomb St
Grosse Ile, MI 48138-1577
Phone (734) 676-6000
Other providers in Gibraltar, MI
- Katie Achilli
- Alpha Physicians, PLLC
- Karlie Rose Arp
- Adam Robert Blanton
- Douglas Booker
- William Cain
- City of Gibraltar
- Conscious Mind Psychiatry of Michigan
- Tim Charles Desano
All providers in Gibraltar, MI · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2021. 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.