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General NPI Number Information
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NPI Number | 1356020820
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Entity Type | Individual
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Provider Name | DAVID A KIRKWOOD PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3650 BROADMOOR AVE SE STE 108
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City | GRAND RAPIDS
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State | MI
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Zip | 49512-3926
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Country | US
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Telephone | 616-365-9702
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Fax |
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Provider Business Mailing Address
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Address Line | 17079 JAMES ST
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City | HOLLAND
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State | MI
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Zip | 49424-6037
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Country | US
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Telephone | 616-292-6004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835G0303X
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Taxonomy Name | Geriatric Pharmacist
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License Number | 5302032372
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License Number State | MI
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