Healthcare Provider Details

I. General information

NPI: 1760287759
Provider Name (Legal Business Name): HUSSEIN EL-SIBAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 08/17/2026
Certification Date: 02/14/2025
Deactivation Date: 02/14/2025
Reactivation Date: 08/17/2026

III. Provider practice location address

2375 CEDAR ST STE A
HOLT MI
48842-2119
US

IV. Provider business mailing address

2375 CEDAR ST STE A
HOLT MI
48842-2119
US

V. Phone/Fax

Practice location:
  • Phone: 517-800-0111
  • Fax: 517-800-0222
Mailing address:
  • Phone: 517-800-0111
  • Fax: 517-800-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302038700
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: