MEDICARE: NAHID RAEE

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	5302040926	MI

General Provider Information

NPI Number	:	1164048781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAHID RAEE

Provider Business Mailing Address
First Line	:	6331 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4317
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6331 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4317
Country	:	US
Telephone Number	:	313-567-4239
Fax Number	:

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

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	06/19/2020

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Directions to “ NAHID RAEE ” Practice Location

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