Healthcare Provider Details

I. General information

NPI: 1063099679
Provider Name (Legal Business Name): DEBORAH MARIE PUMARADA FERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH MARIE PUMARADA MD

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4851 E PICKARD ST STE 1000
MT PLEASANT MI
48858-2041
US

IV. Provider business mailing address

4201 SAINT ANTOINE ST # 9C
DETROIT MI
48201-2153
US

V. Phone/Fax

Practice location:
  • Phone: 989-956-9069
  • Fax: 989-956-9073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301514619
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: