Healthcare Provider Details

I. General information

NPI: 1194638361
Provider Name (Legal Business Name): ADHIM NASIR PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24825 MICHIGAN AVE STE C
DEARBORN MI
48124-1758
US

IV. Provider business mailing address

3730 EASTHAM RD
DEARBORN MI
48120-1049
US

V. Phone/Fax

Practice location:
  • Phone: 313-470-0110
  • Fax: 313-470-0111
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416772
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: