Healthcare Provider Details
I. General information
NPI: 1821928417
Provider Name (Legal Business Name): TRUDI BATES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US
IV. Provider business mailing address
3666 CLOVERLAWN AVE
YPSILANTI MI
48197-3705
US
V. Phone/Fax
- Phone: 734-764-7596
- Fax:
- Phone: 734-787-8903
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 5302033172 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: