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Organization

EASTSIDE GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FERNANDO BERMUDEZ MD (MEDICAL DIRECTOR)
(586) 447-5110
Entity
Organization

Contact information

Practice address
28963 LITTLE MACK AVE, SUITE 103, SAINT CLAIR SHORES, MI 48081-3017
(586) 447-5110
Mailing address
28963 LITTLE MACK AVE, SUITE 103, SAINT CLAIR SHORES, MI 48081-3017
(586) 447-5110

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MI
367500000X
Certified Registered Nurse Anesthetist
MI

Other

Enumeration date
06/04/2009
Last updated
06/04/2009
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