Healthcare Provider Details

I. General information

NPI: 1487407516
Provider Name (Legal Business Name): ADAM NABIL ZAWAIDEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 ORCHARD LAKE RD
WEST BLOOMFIELD MI
48322-3403
US

IV. Provider business mailing address

5901 N ADAMS RD
BLOOMFIELD HILLS MI
48304-2007
US

V. Phone/Fax

Practice location:
  • Phone: 248-487-7019
  • Fax: 248-487-9409
Mailing address:
  • Phone: 248-224-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416044
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: