Healthcare Provider Details

I. General information

NPI: 1861194540
Provider Name (Legal Business Name): WASEEM HASSAN ZAGHIR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15450 MICHIGAN AVE
DEARBORN MI
48126-2917
US

IV. Provider business mailing address

7331 PINEHURST ST
DEARBORN MI
48126-1564
US

V. Phone/Fax

Practice location:
  • Phone: 313-584-5820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302415089
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: