Healthcare Provider Details

I. General information

NPI: 1134395908
Provider Name (Legal Business Name): SUNIL S NAIR RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E 8 MILE RD
DETROIT MI
48234-1008
US

IV. Provider business mailing address

1559 DOBRICH STREET
WINDSOR ONTARIO
N9B3W7
CA

V. Phone/Fax

Practice location:
  • Phone: 313-892-4600
  • Fax:
Mailing address:
  • Phone: 519-792-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302036987
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: