Healthcare Provider Details

I. General information

NPI: 1356264642
Provider Name (Legal Business Name): HUMA AYYUB AHMAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13031 CONANT ST
HAMTRAMCK MI
48212-2361
US

IV. Provider business mailing address

13031 CONANT ST
HAMTRAMCK MI
48212-2361
US

V. Phone/Fax

Practice location:
  • Phone: 313-893-3339
  • Fax: 313-893-3337
Mailing address:
  • Phone: 313-893-3339
  • Fax: 313-893-3337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5315254411
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302417133
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: