Healthcare Provider Details

I. General information

NPI: 1831003961
Provider Name (Legal Business Name): ALI KALIL SMIDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45300 CHERRY HILL RD
CANTON MI
48187-5073
US

IV. Provider business mailing address

45300 CHERRY HILL RD
CANTON MI
48187-5073
US

V. Phone/Fax

Practice location:
  • Phone: 734-981-3968
  • Fax:
Mailing address:
  • Phone: 734-981-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419365
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: