Healthcare Provider Details

I. General information

NPI: 1205745544
Provider Name (Legal Business Name): DR. MANAR MAAN HANNAKACHL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 10/01/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 TWENTY FIVE MILE RD.
SHELBY TOWNSHIP MI
48316
US

IV. Provider business mailing address

2115 TWENTY FIVE MILE RD.
SHELBY TOWNSHIP MI
48316
US

V. Phone/Fax

Practice location:
  • Phone: 248-835-2880
  • Fax:
Mailing address:
  • Phone: 248-835-2880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419294
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: