Evan Brikho, PHARM.D
Individual provider Active NPI Pharmacist · Lake Orion, MI
NPI 1407444979 · NPPES record last updated Jan 9, 2021
Key facts
- NPI
- 1407444979
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302039046 (MI)
- Practice address
- 1412 S Lapeer Rd
Lake Orion, MI 48360-1437 - Phone
- (248) 690-9686
- Fax
- (248) 690-9687
- NPI assigned
- Jan 9, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302039046 | MI | MD | Pharmacist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302039046 | MI | Yes |
Addresses
Primary practice location
1412 S Lapeer Rd
Lake Orion, MI 48360-1437
Mailing address
1412 S Lapeer Rd
Lake Orion, MI 48360-1437
Phone (248) 690-9686
Other providers in Lake Orion, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.