MEDICARE: MICHELLE MARIE BERDING PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26021507A	IN

General Provider Information

NPI Number	:	1720624687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARIE BERDING PHARMD

Provider Business Mailing Address
First Line	:	172 LOGAN ST
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-1437
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	172 LOGAN ST
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-1437
Country	:	US
Telephone Number	:	317-776-3347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	11/25/2019

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