Provider Demographics
NPI:1780662676
Name:AKKASHIAN, MICHAEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:AKKASHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18167 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 650
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3528
Mailing Address - Country:US
Mailing Address - Phone:727-507-3324
Mailing Address - Fax:
Practice Address - Street 1:18167 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 650
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-3528
Practice Address - Country:US
Practice Address - Phone:727-507-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074105207PE0004X
FLME113464207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10-4413457Medicaid
MI10-4413420Medicaid
MI10-4413466Medicaid
MI10-4413475Medicaid
MI10-4964168Medicaid
MI11270442OtherCAQH PROVIDER ID
MA074105OtherBCBS
MI0108227112OtherBCBS
MI10-4413448Medicaid
MI10-4413439Medicaid
MI10-4964103Medicaid
MI10-4413484Medicaid
MI10-4413493Medicaid
MIH66148Medicare UPIN
MI930119976Medicare ID - Type UnspecifiedRAILROAD MHP
MI10-4413493Medicaid
MI10-4413457Medicaid
Q26294346Medicare PIN
MI930119977Medicare ID - Type UnspecifiedRAILROAD PEC
MI10-4413420Medicaid