Provider Demographics
NPI:1174111371
Name:HUSSAIN, SYED AKHYAR (PHARMD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:AKHYAR
Last Name:HUSSAIN
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 1:2950 KEEWAHDIN RD
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3526
Mailing Address - Country:US
Mailing Address - Phone:810-689-1119
Mailing Address - Fax:
Practice Address - Street 1:2950 KEEWAHDIN RD
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3526
Practice Address - Country:US
Practice Address - Phone:810-689-1119
Practice Address - Fax:810-824-4714
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist