Provider Demographics
NPI:1194359497
Name:AKPOR-MENSAH, ROSTIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSTIAN
Middle Name:
Last Name:AKPOR-MENSAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ROSTIAN
Other - Middle Name:
Other - Last Name:MENSAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2222 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53206-1941
Mailing Address - Country:US
Mailing Address - Phone:414-305-7131
Mailing Address - Fax:414-871-0170
Practice Address - Street 1:2222 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53206-1941
Practice Address - Country:US
Practice Address - Phone:414-305-7131
Practice Address - Fax:414-871-0170
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18194-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist