Healthcare Provider Details

I. General information

NPI: 1942005475
Provider Name (Legal Business Name): MARIAM NABIL TOMA SAEGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20903 HARPER AVE
HARPER WOODS MI
48225-1132
US

IV. Provider business mailing address

20903 HARPER AVE
HARPER WOODS MI
48225-1132
US

V. Phone/Fax

Practice location:
  • Phone: 313-642-0942
  • Fax: 313-642-0964
Mailing address:
  • Phone: 313-642-0942
  • Fax: 313-642-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302417030
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: