MEDICARE: MOHAMED SALEH HUSSAIN

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	5302414795	MI

General Provider Information

NPI Number	:	1437932647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED SALEH HUSSAIN

Provider Business Mailing Address
First Line	:	3006 SALINA ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1449
Country	:	US
Telephone Number	:	313-985-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	407 E CHICAGO ST
Second Line	:
City	:	COLDWATER
State	:	MI
Zip	:	49036-2044
Country	:	US
Telephone Number	:	313-985-2588
Fax Number	:

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

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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