Provider Demographics
NPI:1467538785
Name:ALKAMANO, IHSAN Y (RPH)
Entity Type:Individual
Prefix:
First Name:IHSAN
Middle Name:Y
Last Name:ALKAMANO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:Y
Other - Last Name:ALKAMANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1995 LONE PINE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2522
Mailing Address - Country:US
Mailing Address - Phone:248-909-6572
Mailing Address - Fax:313-928-5159
Practice Address - Street 1:4058 W JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:ECORSE
Practice Address - State:MI
Practice Address - Zip Code:48229-1749
Practice Address - Country:US
Practice Address - Phone:313-928-2700
Practice Address - Fax:313-928-5159
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302027308OtherPHARMACIST LICENSE #