Provider Demographics
NPI:1073616173
Name:HAKIMI, AZRA (MD)
Entity Type:Individual
Prefix:
First Name:AZRA
Middle Name:
Last Name:HAKIMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 RAMBLING DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:586-944-7881
Mailing Address - Fax:
Practice Address - Street 1:46591 ROMEO PLANK
Practice Address - Street 2:SUITE 131
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044
Practice Address - Country:US
Practice Address - Phone:586-226-6000
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065557208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics