Individual
SUSAN MARIE VENDEMELIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 880-2439
Mailing address
54653 FRANKLIN DR, SHELBY TOWNSHIP, MI 48316-1622
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
5302033038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456
DO NOT HAVE NUMBERS
—
Enumeration date
08/09/2017
Last updated
06/16/2018
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