Basic Information
| Provider Information | |||||||||
| NPI: | 1679927578 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AKRAWE | ||||||||
| FirstName: | SANDY | ||||||||
| MiddleName: | PAULINE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4101 BRANDYWYNE DR | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480984263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486357524 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2185 CITRACADO PKWY | ||||||||
| Address2: | |||||||||
| City: | ESCONDIDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920294159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4422814047 | ||||||||
| FaxNumber: | 7604800194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2016 | ||||||||
| LastUpdateDate: | 09/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 173310 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.