Individual
MICHAEL M BERMUDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3630 WILLOWCREEK RD, PORTAGE, IN 46368-5075
(219) 364-3000
Mailing address
149 RAINBOW DRIVE #4918, LIVINGSTON, TX 77399-1049
(316) 841-4324
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101241235
VA
207P00000X
Emergency Medicine Physician
01061935A
IN
207P00000X
Emergency Medicine Physician
208568
NY
207P00000X
Emergency Medicine Physician
36266
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649213554
—
VA
Enumeration date
06/14/2006
Last updated
07/07/2008
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