Healthcare Provider Details

I. General information

NPI: 1770448128
Provider Name (Legal Business Name): ABDULLA MOHAMED SHARIFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10136 VERNOR HWY
DEARBORN MI
48120-1515
US

IV. Provider business mailing address

10136 VERNOR HWY
DEARBORN MI
48120-1515
US

V. Phone/Fax

Practice location:
  • Phone: 313-258-6660
  • Fax: 313-841-8846
Mailing address:
  • Phone: 313-258-6660
  • Fax: 313-841-8846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302033266
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: