Healthcare Provider Details

I. General information

NPI: 1831843408
Provider Name (Legal Business Name): MISS RABAB SAAB AWADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RABAB JAMIL AWADA RABAB AWADA

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29451 PLYMOUTH RD
LIVONIA MI
48150-2112
US

IV. Provider business mailing address

7529 STEADMAN ST
DEARBORN MI
48126-1373
US

V. Phone/Fax

Practice location:
  • Phone: 734-793-0638
  • Fax:
Mailing address:
  • Phone: 313-627-1032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5303040937
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416974
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: