Individual provider Active NPI

Wael Elkafarneh

  • Pharmacotherapy Pharmacist
  • Allen Park, MI
National Provider Identifier
1578973830
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
5302032516 Issued in MI
Practice address
3565 Fairlane Dr
Allen Park, MI 48101-2876
Phone
(313) 253-1133
NPI assigned
May 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 5302032516 MI Primary

Addresses

Primary practice location

3565 Fairlane Dr
Allen Park, MI 48101-2876

Mailing address

3565 Fairlane Dr
Allen Park, MI 48101-2876
Phone (313) 253-1133

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

LicenseStateTypeSpecialty
5302032516MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1578973830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 FAIRLANE DR",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012876",
            "telephone_number": "313-253-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 FAIRLANE DR",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012876",
            "telephone_number": "313-253-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKAFARNEH",
        "first_name": "WAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-07",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302032516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.