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NPI Code Detail

MEDICARE: ETORNAM AKU DOE

MEDICARE: ETORNAM AKU DOE
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
1183500000XPharmacistS027587AZ

General Provider Information

NPI Number : 1972489151
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETORNAM AKU DOE
Provider Business Mailing Address
First Line : 23565 N SCOTTSDALE RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-3463
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23565 N SCOTTSDALE RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-3463
Country : US
Telephone Number : 480-585-9650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2025
Last Update Date : 03/04/2026

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Directions to “ ETORNAM AKU DOE ” Practice Location

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