Wafa Altamam
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Canton, MI
NPI 1417596453 · NPPES record last updated Dec 21, 2019
Key facts
- NPI
- 1417596453
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 5315123397 (MI)
- Practice address
- 45540 Michigan Ave
Canton, MI 48188-2472 - Phone
- (734) 397-2560
- NPI assigned
- Dec 21, 2019
- Sex
- Female
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5315123397 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co of Michigan | Past |
Accepting new patients | |
| Kroger Co of Michigan | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5315123397 | MI | Yes |
Addresses
Primary practice location
45540 Michigan Ave
Canton, MI 48188-2472
Mailing address
45540 Michigan Ave
Canton, MI 48188-2472
Phone (734) 397-2560
Other providers in Canton, MI
- Alpha Home Healthcare Services, Inc.
- Mahmoud Mohammad Alrfifeh
- Karam Alrousan
- Ali Alsaden
- Razan Alshuwayhat
- Bassel Altantawi
- Kelly Alter
- Summer Alwakya
- Daniel Chinthaka Amarasinghe
- Hira Amarasinghe
All providers in Canton, MI · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2019. 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.