Provider Demographics
NPI:1083615504
Name:AFMAN, JUDSON K (R PH)
Entity Type:Individual
Prefix:MR
First Name:JUDSON
Middle Name:K
Last Name:AFMAN
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-1365
Mailing Address - Country:US
Mailing Address - Phone:231-924-3599
Mailing Address - Fax:231-924-6310
Practice Address - Street 1:30 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1244
Practice Address - Country:US
Practice Address - Phone:231-924-2120
Practice Address - Fax:231-924-6310
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist