Healthcare Provider Details

I. General information

NPI: 1851069405
Provider Name (Legal Business Name): ADAM AQEL DOCTOR OF PHARMACY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 EAST PARIS AVE SE STE 220
GRAND RAPIDS MI
49546-6195
US

IV. Provider business mailing address

1080 SKYEVALE NE
ADA MI
49301-8125
US

V. Phone/Fax

Practice location:
  • Phone: 616-548-6161
  • Fax:
Mailing address:
  • Phone: 616-206-4316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302413691
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: