Healthcare Provider Details

I. General information

NPI: 1598489502
Provider Name (Legal Business Name): ADAM OBAID
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ANN ARBOR RD W
PLYMOUTH MI
48170-2127
US

IV. Provider business mailing address

800 ANN ARBOR RD W
PLYMOUTH MI
48170-2127
US

V. Phone/Fax

Practice location:
  • Phone: 734-737-0218
  • Fax:
Mailing address:
  • Phone: 734-737-0218
  • Fax: 734-737-0506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302414794
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: