Healthcare Provider Details

I. General information

NPI: 1063320257
Provider Name (Legal Business Name): HUIJUN YAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

1977 SUTTON PLACE DR
TROY MI
48098-6648
US

V. Phone/Fax

Practice location:
  • Phone: 313-593-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302041528
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: