Healthcare Provider Details

I. General information

NPI: 1669387809
Provider Name (Legal Business Name): SAMA ALI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51000 ROMEO PLANK RD
MACOMB MI
48042-4128
US

IV. Provider business mailing address

43259 HERRING DR
CLINTON TOWNSHIP MI
48038-4447
US

V. Phone/Fax

Practice location:
  • Phone: 586-992-8570
  • Fax:
Mailing address:
  • Phone: 586-453-9805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419152
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: