Provider Demographics
NPI:1487381810
Name:AKRAM, AZFAR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:AZFAR
Middle Name:
Last Name:AKRAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-3038
Mailing Address - Country:US
Mailing Address - Phone:631-530-2583
Mailing Address - Fax:
Practice Address - Street 1:608 WILSON DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-3038
Practice Address - Country:US
Practice Address - Phone:631-530-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2023-03-21
Deactivation Date:2023-03-10
Deactivation Code:
Reactivation Date:2023-03-21
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI5302414913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician