Healthcare Provider Details

I. General information

NPI: 1760386981
Provider Name (Legal Business Name): RAGHEED RABBAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6294 ORCHARD WOODS DR
WEST BLOOMFIELD MI
48324-3286
US

IV. Provider business mailing address

6294 ORCHARD WOODS DR
WEST BLOOMFIELD MI
48324-3286
US

V. Phone/Fax

Practice location:
  • Phone: 248-310-3924
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5315212992
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: