Provider Demographics
NPI:1962048900
Name:AFLAK, HAZAR
Entity type:Individual
Prefix:
First Name:HAZAR
Middle Name:
Last Name:AFLAK
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 1:1821 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-1344
Mailing Address - Country:US
Mailing Address - Phone:810-721-3262
Mailing Address - Fax:810-721-3263
Practice Address - Street 1:1821 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-1344
Practice Address - Country:US
Practice Address - Phone:810-721-3262
Practice Address - Fax:810-721-3263
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020305151835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist