Active NPI
Mikaelin Yaldo
- Pharmacist
- Southfield, MI
National Provider Identifier
1184448219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302413986
- Practice address
- 24681 Northwestern Hwy Ste 4010
Southfield, MI 48075-2305 - Phone
- (248) 200-8225
- NPI assigned
- Nov 14, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5315252283 | MI | |
| Pharmacist | 183500000X | 5302413986 | MI | Primary |
Addresses
Primary practice location
24681 Northwestern Hwy Ste 4010
Southfield, MI 48075-2305
Mailing address
24681 Northwestern Hwy Ste 4010
Southfield, MI 48075-2305
Phone (248) 200-8225
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302413986 | MI | MD | Pharmacist |
| 5315252283 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731542400000",
"number": "1184448219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24681 NORTHWESTERN HWY STE 4010",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752305",
"telephone_number": "248-200-8225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24681 NORTHWESTERN HWY STE 4010",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480752305",
"telephone_number": "248-200-8225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YALDO",
"first_name": "MIKAELIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-14",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5315252283",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302413986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.