Healthcare Provider Details

I. General information

NPI: 1124285994
Provider Name (Legal Business Name): CARLIN E JAMIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 14 MILE RD
CLAWSON MI
48017-2803
US

IV. Provider business mailing address

1301 W 14 MILE RD
CLAWSON MI
48017-2803
US

V. Phone/Fax

Practice location:
  • Phone: 248-435-2410
  • Fax: 248-435-4538
Mailing address:
  • Phone: 248-435-2410
  • Fax: 248-435-4538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302035009
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: