Provider Demographics
NPI:1881225563
Name:ANIL-GEORGE, LEKHA
Entity Type:Individual
Prefix:
First Name:LEKHA
Middle Name:
Last Name:ANIL-GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 PEMBROKE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5730
Mailing Address - Country:US
Mailing Address - Phone:248-608-8911
Mailing Address - Fax:
Practice Address - Street 1:1526 PEMBROKE DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5730
Practice Address - Country:US
Practice Address - Phone:248-608-8911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist