MEDICARE: SANDY HAKIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302413129	MI

General Provider Information

NPI Number	:	1720660509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY HAKIM

Provider Business Mailing Address
First Line	:	4346 15 MILE RD
Second Line	:
City	:	STERLING HTS
State	:	MI
Zip	:	48310-5409
Country	:	US
Telephone Number	:	586-854-2861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 COOLIDGE HWY
Second Line	:
City	:	BERKLEY
State	:	MI
Zip	:	48072-3040
Country	:	US
Telephone Number	:	248-546-9111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2021
Last Update Date	:	04/22/2021

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Directions to “ SANDY HAKIM ” Practice Location

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